Some people who smoke may have a lower risk of gout, but nicotine isn’t necessarily the reason why. If your gout risk is reduced while smoking, it may have more to do with the complex relationship between oxidative stress and uric acid levels.

Smoking tobacco products is hazardous for your health. It negatively affects almost every organ of your body and is a contributing factor in many chronic health conditions and premature deaths.

Despite all the negatives, research occasionally finds a positive feature of smoking, like reduced gout risk. Gout is a painful type of arthritis that develops when monosodium urate crystals accumulate in your joints, but smokers appear to have a lower risk for this condition.

This article will look into the full context of this phenomenon.

Too-high uric acid levels, known as hyperuricemia, cause uric acid to accumulate in the joints, where it binds with sodium to form monosodium urate crystals. These crystals cause the hallmark inflammation, swelling, and pain of gout.

Nicotine, specifically, has not been proven to reduce your risk for gout. A growing body of research suggests that smoking tobacco is associated with reduced gout risk through the reduction of uric acid levels in the bloodstream.

Smokers appear to have lower uric acid levels, which can mean they’re at a reduced risk of developing gout.

In 2014, a large-scale epidemiological study found cigarette smoking was linked to a lower risk for gout, even when taking into account a person’s individual risk factors.

As experts continue to investigate the link between smoking and reduced risk for gout, however, the relationship becomes less straightforward.

Not all types of tobacco use lower your risk. A large-scale Korean study from 2021 found electronic cigarette (e-cigarette) use was associated with higher uric acid levels in the blood. People who were “dual” smokers (used both conventional cigarettes and e-cigarettes) also had higher levels of uric acid in their bloodstream.

The same findings on dual smoking were reported in a 2023 cross-sectional study, which also noted men were more likely than women to have the highest uric acid levels when dual smoking.

As one of the best-known components in cigarettes, nicotine is often assumed to play a role in many of smoking’s effects. When it comes to reducing gout risk, however, evidence points to a different contributing factor: oxidative stress.

Oxidative stress describes an imbalance in your body between the production of free radicals, highly reactive molecules, and your ability to detoxify those molecules.

An older study from 2008 suggested that increased oxidative stress from smoking was the reason that uric acid levels in smokers were low. Uric acid is a powerful antioxidant in the body used to combat free radicals. In theory, the increased oxidative stress caused by smoking could trigger your body to utilize more uric acid, lowering its levels in your blood.

A 2023 cross-sectional study looking at the effects of cigarette smoking on uric acid levels in people with multiple sclerosis concluded lower levels of uric acid seen among smokers were likely due to the oxidative stress response.

Ultimately, more research is necessary to understand why your risk of gout may be lower if you smoke conventional cigarettes.

Even though nicotine might not be the main reason why smoking lowers gout risk in some people, it may still hold promise in the future as a treatment for gout.

Nicotine is an anti-inflammatory alkaloid and has been investigated for use in a wide range of inflammatory conditions like inflammatory bowel disease, arthritis, and multiple sclerosis.

As an arthritic condition, gout is a potential target for future medical nicotine therapy.

That doesn’t mean smoking will improve your symptoms of gout, though. In fact, The Arthritis Foundation indicates smoking is one of the most well-known environmental triggers of arthritis inflammation.

Cigarettes contain thousands of other chemicals in addition to nicotine, many of which are linked to cancer and create a body-wide inflammatory response that can compound joint swelling and pain.

Yes, smoking has been well-established as a cause of increased inflammation in joints as well as the development of rheumatoid arthritis (RA).

In addition to smoking, secondhand smoke has also been found to cause RA. A study from 2021 found that even experiencing secondhand smoke as a child increased the risk of developing RA as an adult.

This does not rule out nicotine as a future therapy for joint inflammation. Researchers continue to explore anti-inflammatory pathways that can be influenced by nicotine without triggering its pro-inflammatory effects.

Nicotine has not been proven to reduce gout risk. Current research links tobacco smoking, not nicotine, to lower levels of uric acid in the bloodstream.

While nicotine is a major ingredient in tobacco smoke, oxidative stress may be the more significant underlying cause of reduced risk for gout.

Any potential benefits of cigarette smoking are still heavily outweighed by its negative effects.