Smoking and axSpA


Can smoking affect your axial spondyloarthritis?

If you have been diagnosed with axial spondyloarthritis (axSpA) and smoke, you could be at risk of worsening your symptoms and increasing your risk of cardiovascular disease, respiratory disease and cancer. There is a link between smoking and increased spinal damage in people with axSpA. Smoking has also been linked to increased disease activity, more widespread joint pain and fatigue. 

Research has found that people with axSpA who stop smoking have lower disease activity, better physical function, quality of life and overall health compared to smokers. 

How smoking increases the severity of symptoms is not exactly known. Studies suggest that smoking can drive inflammation.

Can smoking affect your treatment?

Research suggests that patients who smoke have a poorer response to treatment. Studies have found that axSpA patients who smoked and were being treated with anti-TNF inhibitors, a type of biological therapy, did not respond as well to treatment as non-smokers. It is believed that smoking may interfere with the body’s ability to absorb these medications.

The good news is that quitting smoking can help the improve people’s response to therapies.

What about e-cigarettes?

E-cigarettes, also known as vaping, are electronic cigarettes that use battery-operated vaporises with flavoured liquid that releases nicotine and chemicals into your lungs and bloodstream when inhaled. Many people choose to smoke e-cigarettes because they believe it is less harmful than cigarettes. Although, research indicates that e-cigarettes may have less chemicals than regular cigarettes, they are still bad for your health. E-cigarettes have been linked to bone density and mineral loss, an increase in blood pressure and heart rate, and reduces effectiveness of some medications. Health practitioners advise against smoking e-cigarettes, especially if you have an inflammatory condition, like axSpA as it may exacerbate the symptoms.

What steps can you take to quit smoking?

Not everyone can quit smoking the same way and what might work for one person may not work for you. It may take a few attempts before you stop smoking completely, but the effort it worth it. Here are a few tips to help you quit smoking:

  • Call the Quitline 13 78 48 to speak with a trained Quit Specialist who can provide advice, encouragement, and support to help you quit.
  • Get help from you doctor who can help develop a strategy and provide advice on nicotine replacement therapies.
  • Tell family and friends who help support and encourage you to quit smoking.
  • Discard all cigarettes, lighters, ashtrays and if you partner smokes, suggest they stop too or only smoke outside and away from you.
  • Go for a walk, drink lots of water and try to find ways to distract yourself when you have a craving.
  • Try to avoid coffee or tea as the caffeine may induce anxiety or restlessness. 


This resource has been developed based on the best available evidence. A full list of references are available upon request.