Cozier YC, et al. - Associations of smoking and alcohol consumption with risk of incident systemic lupus erythematosus (SLE) among black women were investigated using data from a long-term, prospective follow-up study. This first large study among black women identified an increased risk of SLE in association with cigarette smoking and decreased risk with moderate alcohol consumption. These findings among black women are thus consistent with previous findings in other populations.

Methods

• In 1995, researchers undertook the Black Women's Health Study enrolling 59,000 Black women.
• Data on demographics, health status, and medical and lifestyle variables were collected.
• Incident disease was identified and risk factors were updated via follow-up questionnaires every two years.
• Via medical record review, they confirmed incident SLE meeting American College of Rheumatology 1997 criteria.
• They estimated hazard ratios (HRs) and 95% confidence intervals (CI) for associations of cigarette smoking and alcohol intake with incidence of SLE using Cox regression models.

Results

• During 1995-2015, 127 incident SLE cases were identified; mean age: 43 at diagnosis.
• Ever smokers vs never smokers were at higher risk of SLE, albeit not significant (HR = 1.45, 95% CI 0.97-2.18).
• Similar risk was evident for current and past smoking; the risk increased non-significantly with increasing pack-years.
• For current drinking, the HR was 0.71 (95% CI 0.45-1.12), compared to never drinking, with a HR of 0.43 (95% CI 0.19-0.96) for ≥4 drinks/week.