Association between Smoking and Dupuytren Contracture: A Systematic Review and Meta-Analysis

Smoking is a commonly cited risk factor for Dupuytren disease; however, evidence on both the directionality and strength of its association has remained inconclusive. The current study aimed to quantify the association between smoking and the prevalence of Dupuytren disease.

A systematic database search was conducted to identify comparative studies reporting Dupuytren disease prevalence in smokers and nonsmokers (CRD420251043113). Results were pooled using pairwise meta-analysis with a random-effects model.

Twenty-two studies were included in the analysis, encompassing 609,195 smokers and 906,297 nonsmokers. The prevalence of Dupuytren disease was 5.6% among smokers and 4.4% among nonsmokers. Current active smokers were at increased odds of Dupuytren disease compared with nonsmokers (OR, 1.45; 95% CI, 1.06 to 1.98; I ² = 95.8%). To a lesser degree, this risk was also increased among former smokers (OR, 1.39; 95% CI, 1.14 to 1.7; I ² = 97.5%). Overall, any smoking history conferred a 1.5-fold increased odds for Dupuytren disease (OR, 1.50; 95% CI, 1.20 to 1.88; I ² = 95.5%), which remained statistically significant on exclusion of studies with high risk of bias and leave-one-out sensitivity analysis.

This study found a statistically significant association of smoking with Dupuytren disease. Smoking cessation should be encouraged in patients with Dupuytren disease, although further research is needed to identify whether smoking cessation could slow disease progression or prevent recurrence.