Patients with multiple sclerosis are at raised risk of their disease progressing if they continue to smoke, new research suggests.
Dr Jan Hillert of the Karolinska Institutet in Stockholm, Sweden, and colleagues point out that multiple sclerosis disease-modifying treatments are expensive, and not fully effective at delaying the secondary progressive stage of the disease.
Cigarette smoking is a known risk factor for multiple sclerosis, they write in today’s (9 September) issue of JAMA Neurology. Disease development is 20% to 50% more likely in smokers than non-smokers, "making it a strong avenue for influencing patient outcomes".
Previous studies "have not specifically assessed the period after diagnosis or whether continued smoking affects the disease course", so they investigated further. They carried out a study of 728 multiple sclerosis patients who smoked at diagnosis.
Analysis showed that "each additional year of smoking after diagnosis accelerated the time to secondary progressive disease by 4.7%". They add: "Those who continued to smoke continuously each year after diagnosis converted to secondary progressive disease faster than those who quit smoking, reaching secondary progressive disease at 48 and 56 years of age, respectively."
They write: "We propose that patients with multiple sclerosis should be advised to stop smoking once a diagnosis has been made, not only to lessen risks for comorbidities, but also to avoid aggravating multiple sclerosis-related disability. Health care services for patients with multiple sclerosis should be organized to support such a lifestyle change."
In an editorial, Dr Myla Goldman of the University of Virginia, USA, adds: "Even after multiple sclerosis diagnosis, smoking is a risk factor worth modifying."
Ramanujam, R. et al. Effect of Smoking Cessation on Multiple Sclerosis Prognosis. JAMA Neurology 9 September 2015 doi:10.1001/jamaneurol.2015.1788.
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