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Arthritis Care Res (Hoboken). 2018 Aug 9. doi: 10.1002/acr.23703. [Epub ahead of print]

Relationship of cigarette smoking and alcohol consumption to incidence of systemic lupus erythematosus in the Black Women's Health Study.

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Slone Epidemiology Center at Boston University, Boston, MA.
Rheumatology, Department of Medicine, Hospital for Special Surgery, New York, NY.
Division of Rheumatology, Immunology, and Allergy, Department of Medicine, Brigham and Women's Hospital, Boston, MA.



Systemic lupus erythematosus (SLE) affects Black women more frequently than other racial-gender groups. In past studies, largely of Whites and Asians, cigarette smoking was associated with increased SLE risk and moderate alcohol consumption with decreased SLE risk. We used data from a long-term, prospective follow-up study to assess associations of smoking and alcohol consumption with risk of incident SLE among Black women.


The Black Women's Health Study enrolled 59,000 Black women in 1995 and collected data on demographics, health status, and medical and lifestyle variables. Follow-up questionnaires every two years identified incident disease and updated risk factors. We confirmed incident SLE meeting American College of Rheumatology 1997 criteria through medical record review. We used Cox regression models to estimate hazard ratios (HRs) and 95% confidence intervals (CI) for associations of cigarette smoking and alcohol intake with incidence of SLE.


We confirmed 127 incident SLE cases during 1995-2015 (mean age 43 at diagnosis). Compared to never smokers, the risk of SLE among ever smokers was elevated but not significantly (HR = 1.45, 95% CI 0.97-2.18). Risk was similar for current and past smoking and increased non-significantly with increasing pack-years. The HR was 0.71 (95% CI 0.45-1.12), for current drinking relative to never drinking, with a HR of 0.43 (95% CI 0.19-0.96) for ≥4 drinks/week.


Findings from this first large study among Black women are consistent with previous findings in other populations of increased risk of SLE associated with cigarette smoking and decreased risk with moderate alcohol consumption. This article is protected by copyright. All rights reserved.


SLE ; alcohol; black women; cigarette; prospective; risk factor; smoking; systemic lupus erythematosus

[Available on 2020-02-09]

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