Does smoking increase the risk of developing interstitial lung disease in arthritis patients?

Interstitial lung disease (ILD) is a group of lung conditions that cause scarring and inflammation. People with certain types of arthritis, like psoriatic arthritis, have a higher chance of developing ILD. Smoking is a known risk factor for ILD in the general population, and studies show it also raises the risk for arthritis patients.

What the research says

A 2024 review on smoking-related ILD confirms that smoking is a risk factor for several types of ILD, including those that can occur in arthritis patients ⁹. In people with psoriatic arthritis, a meta-analysis found that the overall prevalence of ILD is about 3%, but it is higher (6%) when using advanced imaging like CT scans. Importantly, smoking was associated with a higher risk of ILD in this group ³. Another study on global burden of chronic respiratory diseases also lists smoking as a key risk factor for ILD ¹⁰. Additionally, combined pulmonary fibrosis and emphysema, a syndrome often linked to smoking, can occur in patients with fibrotic ILD ¹¹. While these sources focus on ILD in general, they support that smoking increases ILD risk, and this applies to arthritis patients as well.

What to ask your doctor

• Given my arthritis diagnosis, what is my personal risk for developing interstitial lung disease?
• If I smoke, how much does that increase my risk, and what resources can help me quit?
• Should I have any lung function tests or imaging to check for early signs of ILD?
• Are there any specific symptoms of ILD I should watch for, like shortness of breath or a dry cough?
• How does my arthritis treatment interact with lung health, especially if I have risk factors like smoking?