Objective:To observe the influence of smoking in the levels of blood lipids and disease activity in the male patients with rheumatoid arthritis(RA), and to provide economical and effective intervention for the RA patients. Methods:A total of 112 male patients with RA were selected.The fasting blood samples from the ulnar vein of all patients were obtained in the morning. The level of C-reaction protein (CRP), erythrocyte sedimentation rate (ESR), total cholesterol (TC), triglyceride (TG), high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C) and other indicators were measured. The smoking status (including years of smoking, number of cigarettes smoked per day), tender joint count (TJC), swollen joint count (SJC) and other clinical data were collected and 28-joint disease activity score (DAS28) was calculated.The patients were divided into smoking group (87 cases) and non-smoking group (25 cases).According to the smoking index (SI)(years of smoking multiplied by number of cigarettes smoked per day), the patients were divided into group A (less than 400) (34 cases), group B (between 400 to 800) (37 cases) and group C (more than 800) (16 cases).Results:The levels of TC and TG of the patients in smoking group were significantly higher than those in non-smoking group(P<0.01), the HDL-C level was lower(P<0.01), and there was no significant difference in the LDL-C level between two groups(P>0.05).W ith the increase of SI, the levels of TC and TG were increased(P<0.05), and the HDL-C levels were decreased(P<0.05);the LDL-C levels were increased, but there was no significant difference between various groups(P>0.05).The levels of CRP and ESR in smoking group were higher than those in non-smoking group (P<0.05).The TJC, SJC, and DAS28 of the patients in smoking group were significantly higher than those in non-smoking group(P<0.01).With the increase of SI, the TJC, SJC, and DAS28 were increased(P<0.05), and the CRP and ESR levels showed an increasing trend.Conclusion:Smoking may cause the abnormal blood lipid levels in the patients with RA and the increased disease activity.To quit or reduce smoking may improve blood lipid metabolism in the patients with RA and has a positive effect on reducing the risk of RA.