It’s well known that smoking is bad for our health, but there’s also strong evidence that smoking is particularly bad for people with MS. It increases your risk of developing MS, causes more frequent relapses, faster increase in disability and an earlier change from relapsing remitting to secondary progressive MS.
Less is known about what happens to your MS when you give up smoking. This study investigated whether quitting smoking has a beneficial effect on MS progression.
Data was collected from health-related questionnaires completed by people signed up to the UK MS Register during the period 2011 to 2020. Researchers compared how the scores to the questionnaires changed over time, with people’s current or previous smoking status. For all measures, higher scores indicate greater disability.
Data was collected for 7983 participants; 3853 (48.2%) were never smokers, 1315 (16.5%) current smokers and 2815 (35.3%) former smokers.
People who were current smokers had higher disability, anxiety and depression compared to those who had never smoked. People who were former smokers had scores which were generally intermediate between never smokers and current smokers. Heavier smoking in both current and former smokers resulted in higher scores. Disability progressed more rapidly for current smokers; people who had given up smoking had a similar rate of progression to people who had never smoked.
This study clearly showed that smoking increases the rate at which disability progresses, but if you quit smoking then your progression slows down to the same rate as somebody who has never smoked.
The take-home message from this study is that it’s never too late to benefit from quitting smoking.
Background
It is well-established that smoking is bad for general health and there’s also strong evidence that smoking is particularly bad for people with MS. Studies have shown that smoking increases your risk of developing MS, is associated with more frequent relapses, leads to a faster increase in disability and an earlier change from relapsing remitting to secondary progressive MS.
However, less is known about what happens to your MS when you give up smoking. This study investigated whether quitting smoking has a beneficial effect on MS progression.
How this study was carried out
Researchers analysed responses from people signed up to the UK MS Register who had regularly filled in health-related questionnaires during the period 2011 to 2020 and had recorded their smoking status (never smokers; former smokers; current smokers). Former and current smokers were asked for the number of cigarettes smoked each day, which were classified as light (≤7), moderate (7–12) and heavy (≥13). Data was collected from three questionnaires which asked participants to assess how MS affected them physically (MSIS-29-Phys), how it affected their walking (MSWS-12) and how it affected them emotionally (HADS). Researchers compared how the scores to the questionnaires changed over time, with people’s current or previous smoking status. For all measures, higher scores indicate greater disability.
What was found?
Data was collected for 7983 participants; 3853 (48.2%) were never smokers, 1315 (16.5%) current smokers and 2815 (35.3%) former smokers.
Analyses were also done to assess the impact of smoking status on scores over a four-year period (923 participants) and to compare how long it took to reach increased disability milestones (4642 participants).
The different analyses gave a similar picture: people who were current smokers had higher disability, anxiety and depression compared to those who had never smoked. People who were former smokers had scores which were generally intermediate between never smokers and current smokers. Heavier smoking in both current and former smokers resulted in higher scores.
Disability progressed more rapidly for current smokers compared to former and never smokers. Former smokers and never smokers had similar rates of progression. However, former smokers continued to have higher disability compared to never smokers, indicating that quitting smoking could not reverse damage that had already occurred.
What does it mean?
This study clearly showed that smoking increases the rate at which disability progresses, but if you quit smoking then your progression slows down to the same rate as somebody who has never smoked.
The take-home message from this is that it’s never too late to benefit from quitting smoking.
The researchers found that the rate of smoking is similar, if not a bit higher, than national levels. They also found that more people self-reported as current or former smokers than was recorded in their medical notes. This may suggest that health professionals are not asking about smoking habits during appointments and that people with MS who smoke are not being encouraged or offered support to quit. Further research is urgently needed to understand smoking behaviour in MS and find the best approach to helping people with MS to quit.
Rodgers J, et al.
The impact of smoking cessation on multiple sclerosis disease progression.
Brain 2022;145(4):1368-1378.
Summary
Full article
There is increasing evidence linking smoking to risk and symptoms in MS. Read our page on smoking and MS for more information.
As smoking is also a risk factor for a range of other conditions such as cancers and cardiovascular disease, giving up, or at least cutting down, is recommended. The good news is that you can improve your blood circulation, immune system health and oxygen levels in the blood within 2-12 weeks of stopping.
Quitting is much easier when you get the right support and there are lots of options to choose from. You could visit your GP to discuss what could work for you. The NHS website has information on giving up smoking and a separate website offers advice, tools and tips to help you quit. You can also get support from UK charities, including QUIT.
