Gout and Tobacco: Smoking Worsens Uric Acid, Inflammation, and Outcomes

Smoking aggravates gout through multiple mechanisms:

1. Raises serum uric acid.
2. Reduces renal urate excretion.
3. Promotes systemic inflammation.
4. Damages joint cartilage.
5. Impairs wound healing.
6. Increases cardiovascular comorbidity.
7. May reduce efficacy of urate‑lowering drugs.
8. Synergizes with other triggers (alcohol, purines).
9. Degrades overall health, complicating management.

Strong recommendation: Quit smoking. Cessation programs, nicotine replacement, varenicline, or bupropion improve success. Benefits for gout and general health are substantial.