Smoking Accelerates Multiple Sclerosis

MS has no cure but giving up cigarettes may put the brakes on worsening symptoms.

In many ways, multiple sclerosis (MS) is baffling. The cause of this central nervous system disease, which disrupts signals between the brain and other parts of the body, is unknown — although many researchers think it’s the result of an autoimmune process. Symptoms range from fairly benign to eventually disabling. Although MS waxes and wanes in some people, it can take a progressive course and eventually impair walking and standing, and even result in paralysis. 

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With about 400,000 Americans and 2.5 million individuals worldwide diagnosed with MS, according to the Multiple Sclerosis Association of America, finding strategies to halt the progressive form of the disease in as many people as possible is an important goal of MS researchers. So far, several drug therapies can help symptoms and may reduce exacerbations. 

And scientists recently found something MS patients can do themselves to slow down disease progression: Don’t smoke. 

Smoking is one of the known risk factors for developing MS in the first place, according to neurologist Jan Hillert, MD, PhD, of the Karolinska Institute in Stockholm. A study by Hillert and his colleagues, published in JAMA Neurology, revealed that people who continue smoking after being diagnosed with MS have accelerated disease progression compared to those who quit smoking immediately after finding out they have MS.

“There are, of course, a number of health risks connected to smoking, but for people diagnosed with such a severe disease as MS, it is especially important to quit smoking immediately,” said Hillert, who heads the Karolinska Institute’s department of clinical neuroscience.

The researchers studied the course of MS in 728 MS patients who smoked at diagnosis. Over 300 of the research subjects kept smoking continuously after finding out they had the disease, 118 stopped soon after diagnosis (within a year), and others stopped over time. 

Hillert and his research team found every additional year of smoking after an MS diagnosis seemed to speed up significant progression of the disease by about 5 percent. The research subjects who continued to smoke experienced progression of their disease at an earlier age (48, on average), too. The smokers who kicked their nicotine habit quickly after learning they had MS didn’t experience significant disease progression until around age 56.

"This study demonstrates that smoking after MS diagnosis has a negative impact on the progression of the disease, whereas reduced smoking may improve patient quality of life, with more years before the development of secondary progressive (SP) disease. Accordingly, evidence clearly supports advising patients with MS who smoke to quit. Health care services for patients with MS should be organized to support such a lifestyle change," the study concluded.

In a commentary accompanying the study results, Myla D. Goldman, MD, of the University of Virginia and Olaf Stüve, MD, PhD, of the University of Texas Southwestern Medical Center at Dallas, noted the research demonstrates that smoking is an important and modifiable risk factor in MS. 

“Most importantly, it provides the first evidence, to our knowledge, that quitting smoking appears to delay onset of secondary progressive MS and provide protective benefit,” they wrote. “Therefore, even after MS diagnosis, smoking is a risk factor worth modifying."

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