Rheumatoid arthritis (RA) is an autoimmune disease that is closely related to environmental, cellular, viral, genetic, sex hormonal and neuropsychiatric factors. It has been well documented that smoking is a risk factor for the development and progression of RA. In addition, smoking may also affect the efficacy of medications in RA. In June 2009, J Rheumatol published a research paper by Derek L et al. This study analyzed the effect of smoking history on the efficacy of TNF antagonists in the treatment of RA. The results confirmed that RA patients who smoked were relatively less responsive to TNF antagonists compared to nonsmokers. Treatment ineffectiveness was seen more often in RA patients who had smoked more heavily and in those who continued to smoke when treatment with TNF antagonists was initiated. The investigators asked patients to fill out a questionnaire about their smoking history when they started treatment with TNF antagonists, and a total of 154 people were surveyed. Smoking history was expressed in pack-years, with 1 pack-years being equivalent to 20 cigarettes per day for one year. RESULTS: There was a trend towards an increased rate of TNF antagonist non-response in RA patients with greater involvement in smoking at 3 and 12 months of treatment with TNF antagonists (p (trend) 0.008 and 0.003, respectively). The disease activity of patients (expressed by DAS28) was inversely correlated with the amount of smoking involvement within 3 months of treatment (r = C0.28, p = 0.002). The relationship between the amount of cumulative smoking and the non-response rate to TNF antagonists was not affected by age, sex, disease duration, disease activity at baseline (DAS28), HAQ value (Health Assessment Questionnaire), IgM-type rheumatoid factor (rheumatoid factor), and smoking or not at enrollment.