Healthy Living

Multiple Sclerosis and Smoking - Warnings on the Link Between the Two

It is known that smoking causes health problems for anyone. What is the particular link between MS and smoking?

Multiple Sclerosis and Smoking - Warnings on the Link Between the Two

No one has to tell you that smoking causes severe health problems – there is a scary enough warning on every packet! Today, over 16 million Americans are living with a disease caused by smoking. On a global level, tobacco use causes nearly 6 million deaths per year and by 2030, it is estimated that this number will rise to 8 million.

Numerous studies by research groups have confirmed that individuals who smoke are noted to have higher chances of heart disease, lung cancer, emphysema, and many other respiratory problems, as opposed to individuals who do not smoke. Additionally, is it known for smoking to cause shortness of breath, heartbeat irregularities, and susceptibility to getting lung infections.

Yet, over the years, one particular area of interest has been the link between MS and smoking.

Smoking and MS risk

It was in 2003 that researchers from Norway first demonstrated the link between smoking and the risk of developing MS. According to the study, which involved the medical history of 22,312 individuals in Hordaland, Norway – the risk of MS among individuals who smoked was nearly double that of individuals who had never smoked. Unfortunately, the researchers were unable to pinpoint an exact cause as to why this was the case.

Two years later, in 2005, researchers from the Harvard School of Public Health suggested that three specific risk factors – exposure to Epstein-Barr virus, genetics, and smoking – may interact and substantially increase the risk of developing MS. They gathered data from 1,465 individuals with MS who either smoked, used to smoke or never smoked and derived to the conclusions that:

  • The presence of the HLA-DR15 gene increased the risk of MS by 300%
  • A history of infectious mononucleosis, caused by the Epstein Barr virus, increased the risk by an additional 250%
  • Tobacco use further increased the risk by 150%

Now, recent evidence shows that the link between smoking and risk of developing multiple sclerosis is “clearer than ever” and that smoking could worsen and speed up a mild neurological limitation into a severe disability.

Smoking and MS progression

In a recent study, it has been discovered that quitting smoking could postpone the onset of secondary progressive MS by nearly 8 years. Smoking can cause further damage to the myelin sheath, which is the protective layer that surrounds the nerves and one that is affected in individuals with MS. The damage prohibits the signaling of messages throughout the body and triggers common symptoms such as blurry vision, mobility problems, as well as cognitive impairment.

The study illustrates that it is not just individuals with MS who need to be aware of this, as smokers are also more likely to develop MS. Research also shows an association between smoking and the number/size of brain lesions seen in MRI scans. Increased damage could indicate a lower ability to fight the condition, worsening of symptoms early on, as well as increased relapse rate.

As part of the annual Stoptober campaign, which takes place every October, the MS Society is encouraging any individual with MS who smokes to quit because of the support of thousands of others doing the same thing. “Looking at all the evidence, it’s clear smoking can make MS worse and harder for the brain to fight the condition. Over 100,000 people in the UK have MS and, in light of this review, we are encouraging and supporting every one of them who smokes to quit - it could make a difference to how their MS progresses” said Dr. Susan Kohlhaas, MS Society director of research.

Quitting the habit – for good

In a recent survey, it was found that 89% of individuals with MS do not realize the connection between the risks of smoking and MS. One of these individuals is 43 year old Tamar Packford from Blackpool, England, who was diagnosed with relapsing MS four years ago. “I’ve been smoking about 20 cigarettes a day since I was 16, but had no idea it could be making my condition worse. Obviously, everyone knows cigarettes are bad for you, but I think very few people realize it might affect MS symptoms or make MS progress faster. It’s frightening but, if quitting could keep me out (of) a wheelchair longer, I’m thinking very differently now and definitely considering giving up with some support from the NHS and Stoptober” she said.

Some individuals living with more advanced stages of MS may not see the point in quitting smoking, given that there is no evidence to support the fact that quitting will reverse the course of the disease. However, the benefits of quitting smoking far succeed any perceived benefit cigarettes may have. “MS can be painful and unpredictable, and is often stressful to manage. Some people with MS believe smoking helps them manage stress, and healthcare professionals can be reluctant to take that ally away from someone who’s just been diagnosed. But knowing that continuing to smoke might impact the disease and its progression could make a radical difference to some people” said Dr. Waqar Rashid, consultant neurologist at St George’s Hospital in London.

In the meantime, MS specialists should make sure to have these conversations as a routine part in their MS consultations. Additionally, individuals with MS should take charge of one of the few aspects of their health that they can control. “Most patients will feel uncomfortable (increased anxiety, insomnia, increased craving, gastrointestinal problems, headaches) when they quit smoking for a few days to a couple of weeks initially after quitting, whether they have MS or not, but after withdrawal is completed, they usually feel better” said David Antonuccio, a Professor Emeritus of Psychiatry and Behavioral Sciences with the University of Nevada School of Medicine.

Antonuccio recommends that individuals with MS take advantage of the tools that are provided to them by their doctors/health centers to assist them with quitting. Such tools include trying nicotine replacement therapy, seeking support from friends or family, setting a quit day, using relaxation techniques, discovering healthy behaviors to substitute bad ones, and more. By maintaining a healthy diet, getting plenty of rest, and avoiding unhealthy behaviors, such as smoking, individuals with MS may be able to positively affect the course of the disease. This, in turn, can provide them with a sense of control and an enhanced quality of life.