Is our recommendation for smoking cessation considered in patients with Graves Disease and Graves Orbitopathy?

Objective: Smoking increases the risk of Graves orbitopathy (GO) in patients with Graves disease (GD). Therefore, smoking cessation should be recommended to all patients with GD. This study aimed to investigate whether smoking cessation recommendations were taken into account in patients with GD and whether there was a difference in terms of smoking cessation between those with and without GO. Methods: Smoking status of the cases followed up with GD, who were active smokers when diagnosed, were questioned by telephone visit. The relationship of these data with the presence of GO was evaluated. Results: 74 smokers with GD were included in the study. All patients were advised to quit smoking by their physicians. While the number of cigarettes was 20 (10-22)/day at the first visit, the current cigarette use was 7 (0-15)/day, (p<0.001). Forty-nine (66.2%) of the patients had GO. It was found that 49% of patients with GO and 36% of those without GO quit smoking (p=0.28). The decrease in number of cigarettes/day after physician’s recommendation was significantly higher in patients with GO than patients without GO (-95.4% vs. -54.5%), (p=0.02). Conclusion: Although the importance of smoke cessation was emphasized in all patients with GD, we observed that smoking cessation advice was more followed in the GO group in our study. Explaining in detail that smoking in GD may worsen the course of the disease and impair the quality of life in the possible development of GO, may lead patients to consider smoking cessation recommendations more.

[1]  Chen Ma,et al.  The risk factors for Graves’ ophthalmopathy , 2021, Graefe's Archive for Clinical and Experimental Ophthalmology.

[2]  C. Flück,et al.  Rare forms of genetic steroidogenic defects affecting the gonads and adrenals. , 2021, Best practice & research. Clinical endocrinology & metabolism.

[3]  M. Maguire,et al.  Tobacco counseling in the setting of thyroid eye disease. , 2021, Arquivos brasileiros de oftalmologia.

[4]  W. Wiersinga,et al.  THE 2021 EUROPEAN GROUP ON GRAVES' ORBITOPATHY (EUGOGO) CLINICAL PRACTICE GUIDELINES FOR THE MEDICAL MANAGEMENT OF GRAVES' ORBITOPATHY. , 2021, European journal of endocrinology.

[5]  A. Tirosh,et al.  Quality of life of patients with thyroid eye disease: 3-year follow-up in a multidisciplinary clinic in Israel , 2021, Graefe's Archive for Clinical and Experimental Ophthalmology.

[6]  F. Gianfagna,et al.  Change in newly diagnosed Graves’ disease phenotype between the twentieth and the twenty-first centuries: meta-analysis and meta-regression , 2020, Journal of Endocrinological Investigation.

[7]  R. Niederer,et al.  Thyroid eye disease in New Zealand: interaction between ethnicity and smoking status. , 2020, The New Zealand medical journal.

[8]  Y. Shoenfeld,et al.  Graves' disease: Clinical manifestations, immune pathogenesis (cytokines and chemokines) and therapy. , 2020, Best practice & research. Clinical endocrinology & metabolism.

[9]  M. Edmunds,et al.  Knowledge of Thyroid Eye Disease in Graves' Disease Patients With and Without Orbitopathy. , 2019, Thyroid : official journal of the American Thyroid Association.

[10]  Yau-Huei Wei,et al.  Cigarette Smoke Extract-Induced Oxidative Stress and Fibrosis-Related Genes Expression in Orbital Fibroblasts from Patients with Graves' Ophthalmopathy , 2016, Oxidative medicine and cellular longevity.

[11]  Weiqing Wang,et al.  Smoking was associated with poor response to intravenous steroids therapy in Graves’ ophthalmopathy , 2015, British Journal of Ophthalmology.

[12]  L. Bartalena.  Prevention of Graves' ophthalmopathy. , 2012, Best practice & research. Clinical endocrinology & metabolism.

[13]  W. Wiersinga.  Quality of life in Graves' ophthalmopathy. , 2012, Best practice & research. Clinical endocrinology & metabolism.

[14]  Victor M Montori,et al.  Diagnosis and treatment of hyperprolactinemia: an Endocrine Society clinical practice guideline. , 2011, The Journal of clinical endocrinology and metabolism.

[15]  H. Lemij,et al.  Foveal cone photoreceptor involvement in primary open-angle glaucoma , 2010, Graefe's Archive for Clinical and Experimental Ophthalmology.

[16]  K. Mann.  Risk of smoking in thyroid-associated orbitopathy. , 2009, Experimental and clinical endocrinology & diabetes : official journal, German Society of Endocrinology [and] German Diabetes Association.

[17]  M. Nardi,et al.  Consensus statement of the European group on Graves' orbitopathy (EUGOGO) on management of Graves' orbitopathy. , 2008, Thyroid : official journal of the American Thyroid Association.

[18]  W. Wiersinga.  Combined Thyroid-Eye Clinics , 2007 .

[19]  R. Ziegler,et al.  Smoking and endocrine ophthalmopathy: impact of smoking severity and current vs lifetime cigarette consumption , 1996, Clinical endocrinology.

[20]  A. Sieminski,et al.  Consumption , 1890, The Hospital.

[21]  F. Muñoz-Negrete,et al.  Effectiveness of oral counselling for smoke cessation in Graves orbitopathy patients. , 2019, Archivos de la Sociedad Espanola de Oftalmologia.

[22]  H. C. Hoeck,et al.  Smoking as a risk factor for Graves' disease, toxic nodular goiter, and autoimmune hypothyroidism. , 2002, Thyroid : official journal of the American Thyroid Association.