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These statements suggest that the anti-estrogenic effect of smoking may not have as much importance as its other pleiotropic roles (immunomodulation, activation of redox-sensitive factors, and so forth) in the contribution to the development of ACPA + RA considering the estrogen dependence of the PAD enzyme

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In 2020, the journal Preventing Chronic Disease published a review of the manufacturer-reported nicotine yields of cigarettes sold in the United States from 2013 to 2016 and found that their nicotine content as measured by smoking machines ranged from 0.10 to 3.00 mg per cigarette