OBJECTIVES Through data analysis we will examine and identify the lifestyle factors that impact clinical outcomes of Rheumatoid Arthritis (RA) patients. METHODS Patients' self-reported data was collected from the 2008 RA Patient Survey, an Internet survey of RA patients. We studied the effects of aerobic exercise (>20 minutes a day per month), and cigarette smoking on RA patients. Sign and symptom scores for morning stiffness, fatigue, and pain are defined from 0 (no symptom) to 10 (severe symptom) within the survey. The Health Assessment Questionnaire (HAQ) was used to measure functional status scores (0-3). Quality of life was measured by the mental component score (MCS) and physical component score (PCS) of the Short-Form 36 (SF-36). Productivity was measured by the Work Productivity and Activity Impairment (WPAI) Scale. There were no non-RA controls included in the study. RESULTS A total of 2048 respondents were included in the analysis 1001 patients exercised and 584 patients smoked cigarettes. The average age was 51.9 years and average RA duration was 11.9 years. Patients' mean MCS and PCS scores in the exercise (40.7, 36.7) and non-smoking groups (41.2, 34.4) were significantly higher, than in the non-exercise (40.0, 31.3) and smoking groups (37.4, 32.7). Overall work and productivity impairment was 41.5% (exercise) versus 45.4% (non-exercise), and 45.5% (smoking) versus 42.2% (non-smoking). Signs, symptoms, and HAQ scores were significantly better in the exercise and non-smoking groups (all P<0.05). CONCLUSIONS RA patients who exercise regularly have higher quality of life scores and clinical outcomes. Those that smoke cigarettes have lower quality of life scores and higher symptom/HAQ scores suggesting that this habit may be detrimental to their clinical outcomes. These results suggest that these lifestyle choices influence the overall risk of impairment in RA patients.