ArticleSeminars in arthritis and rheumatism2026
Electronic cigarette use and risk of incident rheumatoid arthritis and systemic lupus erythematosus in the all of us research program.
Article in Seminars in arthritis and rheumatism, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundElectronic cigarettes (e-cigarettes) are increasingly used as a substitute or in addition to cigarettes. Although cigarette smoking is a well-established risk factor for both rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE), the association between e-cigarette use and the development of RA or SLE remains unclear. We investigated e-cigarette use and the risk of incident RA or SLE.
methodsUsing All of Us Research Program (version 8) data, e-cigarette current users were matched by age, sex, race/ethnicity, enrollment year, and cigarette smoking status to non-users, and followed from enrollment until 1st occurrence of RA or SLE, death, end of study period (October 1, 2023), or up to 5 years, whichever first. We estimated incidence rates (IR) and incidence rate ratios (IRR), and calculated hazard ratios (HRs) using Cox models adjusting for other potential confounders. We also performed smoking- and disease state-stratified analyses.
resultsWe identified 15,909 e-cigarette current users and matched non-users. A total of 66 cases of RA or SLE developed among current e-cigarette users in 46,038 person-years vs (IR 1.43/1000 person-years) vs. 43 incident cases among matched non-users in 46,203 person-years (IR 0.93/1000 person-years; IRR 1.54, 95% CI 1.05-2.26; adjusted HR 1.49; 95% CI 1.01-2.20). In stratified analyses, risks were higher among e-cigarette users than non-users who were past or current smokers, and elevated for both RA and SLE, although with smaller sample sizes.
conclusionsCurrent e-cigarette use was associated with an increased risk of RA or SLE. Further studies are needed to evaluate dose-response relationships.
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