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Smoking & Multiple Sclerosis: Everything you need to know

A number of important studies show smoking increases the likelihood of developing MS and of the disease progressing.

Smoking is more dangerous for a person with MS than it is for the average person. Of course, smoking is bad for everyone, and quitting is the single healthiest thing a smoker can do, but that’s even truer for people with MS.

For everyone, smoking can increase the risk of dementia (Livingston 2024) and increases the risk of having trouble with thinking and memory (cognitive impairment) by 50% (NICE) – particularly significant given how common this symptom is in MS (most people with MS – up to 70% – will experience it at some point in their journey) (Di Filippo 2018).

Several important studies show smoking increases the likelihood of developing MS and of the disease progressing.

What do studies say about the relationship between smoking & MS?

  1. Smoking affects MS and is linked with higher levels of disability, anxiety, and worsening of symptoms (Rodgers 2022). 
  2. Stopping smoking significantly slows the rate of motor disability deterioration for people with MS (Rodgers 2022).
  3. Smoking also worsens how well the brain works and stays healthy (Cortese 2020).
  4. The Nurses’ Health Study in 2001 found the risk of getting MS was 1.6 times greater for current smokers, and 1.2 times greater for past smokers than for women who had never smoked. The longer a woman had smoked, the greater her risk of MS; it was highest (1.7 times greater) for those who had smoked for more than 25 years. 
  5. A Norwegian study in 2003 found smokers were 1.8 times likelier to develop MS than non-smokers were.
  6. A 2005 Harvard study found that people with MS who had ever smoked were 3 to 4 times likelier to develop secondary progressive MS than those who had never smoked.
  7. A Swedish study in 2008 confirmed in a group of 122 people with MS that smokers were much more likely to have progressive disease, and to progress at an earlier age.
  8. Second-hand smoke is harmful in MS: A French study showed in 2007 that children were more than twice as likely to get MS if their parents smoked. The longer their exposure, the more likely MS was to develop
  9. A 2008 Austrian study showed that for people who’d had an initial attack suggestive of MS, smokers were nearly twice as likely to develop MS, and to do so earlier than non-smokers
  10. A 2009 Johns Hopkins report noted that subjects who had started smoking before the age of 17 were much more likely to develop MS.
  11. Overcoming MS’s HOLISM study showed that people with MS who smoke not only had a lower quality of life but also a startling 90% increase in the likelihood of major mobility impairments

Despite all this evidence, studies have shown that people with MS smoke more than the general population

For people with MS who still smoke, giving up smoking is likely to positively affect the course of MS. This reasonably simple change can make a big difference in how the disease progresses and to quality of life.

References

1. Cortese M, Munger KL, Martínez-Lapiscina EH, Barro C, Edan G, Freedman MS, Hartung HP, Montalbán X, Foley FW, Penner IK, Hemmer B, Fox EJ, Schippling S, Wicklein EM, Kappos L, Kuhle J, Ascherio A; BENEFIT Study Group. Vitamin D, smoking, EBV, and long-term cognitive performance in MS: 11-year follow-up of BENEFIT. Neurology. 2020 May 5;94(18):e1950-e1960. doi: 10.1212/WNL.0000000000009371

2. Rodgers J, Friede T, Vonberg FW, Constantinescu CS, Coles A, Chataway J, Duddy M, Emsley H, Ford H, Fisniku L, Galea I, Harrower T, Hobart J, Huseyin H, Kipps CM, Marta M, McDonnell GV, McLean B, Pearson OR, Rog D, Schmierer K, Sharrack B, Straukiene A, Wilson HC, Ford DV, Middleton RM, Nicholas R. The impact of smoking cessation on multiple sclerosis disease progression. Brain. 2022 May 24;145(4):1368-1378. doi: 10.1093/brain/awab385

3. Hernan MA, Oleky MJ, Ascherio A. Cigarette smoking and incidence of multiple sclerosis. Am J Epidemiol 2001; 154:69-74

 
4. Riise T, Nortvedt MW, Ascherio A. Smoking is a risk factor for multiple sclerosis. Neurology 2003; 61:1122-1124
 
5. Hernan MA, Jick SS, Logroscino G, et al. Cigarette smoking and the progression of multiple sclerosis. Brain 2005
 
6. Sundstrom P, Nystrom L. Smoking worsens the prognosis in multiple sclerosis. Mult Scler 2008
 
7. Mikaeloff Y, Caridade G, Tardieu M, et al. Parental smoking at home and the risk of childhood-onset multiple sclerosis in children. Brain 2007; 130:2589-2595
 
8. Di Pauli F, Reindl M, Ehling R, et al. Smoking is a risk factor for early conversion to clinically definite multiple sclerosis. Mult Scler 2008
 
9. Weiland TJ, Hadgkiss EJ, Jelinek GA, et al. The association of alcohol consumption and smoking with quality of life, disability and disease activity in an international sample of people with multiple sclerosis. J Neurol Sci 2014; 336:211-219
 
10. Nortvedt MW, Riise T, Maeland JG. Multiple sclerosis and lifestyle factors: the Hordaland Health Study. Neurol Sci 2005; 26:334-339