The effect of cigarette smoking on the severity of knee osteoarthritis in Iraqi patients

Background. Knee joint osteoarthritis (OA) is the most common large joint disorder, imposing an increasing socioeconomic burden, particularly on the aging population. An intricate relationship exists between systemic and local factors that modulate its clinical and radiological presentations, leading to a common final pathway of joint destruction. Objective. This study aimed to investigate the impact of smoking on the severity of knee osteoarthritis. Methods. A cross-sectional study was conducted involving 117 patients with knee OA at the rheumatology outpatient clinic at Al-Hassan Al-Mujtaba Teaching Hospital in Karbala, Iraq, from February 2023 to March 2024. Data were collected through interviews and clinical assessments, focusing on smoking history, knee joint pain intensity, and joint function. OA severity was assessed using clinical and radiological examinations, specifically the Kellgren-Lawrence grading scale. Results. The study demonstrated a substantial association between smoking and heightened pain intensity and diminished joint function. Smokers, particularly males, exhibited significantly higher pain levels and more severe osteoarthritis symptoms compared to non-smoke