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this risk is more profound in men than in women Smoking synergizes with genetic factors such as shared HLA epitopes to create a profoundly increased risk of RA Induction of apoptosis, alteration of cytokine and hormonal balance, immunogenesis of self-antigens, and an influence on lymphocyte function are all mechanisms through which smoking can induce autoimmunity This is a preview of subscription content, access via your institution Access options Subscribe to this journal Receive 12 print issues and online access $189.00 per year only $15.75 per issue Buy this article Purchase on SpringerLink Instant access to the full article PDF