Smoking cessation and the reduction of disability progression in Multiple Sclerosis: a cohort study

Background: Smoking is associated with a more severe disease course in people with multiple sclerosis (MS). The magnitude of effect of smoking cessation on MS progression is unknown. The aim of this study was to quantify the impact of smoking cessation on reaching MS disability milestones. Methods:...

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Main Authors: Tanasescu, Radu, Constantinescu, Cris S., Tench, Christopher R., Manouchehrinia, Ali
Format: Article
Language:English
Published: Oxford University Press 2018
Online Access:https://eprints.nottingham.ac.uk/42104/
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author Tanasescu, Radu
Constantinescu, Cris S.
Tench, Christopher R.
Manouchehrinia, Ali
author_facet Tanasescu, Radu
Constantinescu, Cris S.
Tench, Christopher R.
Manouchehrinia, Ali
author_sort Tanasescu, Radu
building Nottingham Research Data Repository
collection Online Access
description Background: Smoking is associated with a more severe disease course in people with multiple sclerosis (MS). The magnitude of effect of smoking cessation on MS progression is unknown. The aim of this study was to quantify the impact of smoking cessation on reaching MS disability milestones. Methods: This is a cross-sectional study with retrospective reports. A comprehensive smoking questionnaire was sent to 1270 patients with MS registered between 1994 and 2013 in the Nottingham University Hospital MS Clinics database. Demographic and clinical data were extracted from the clinical database. Cox proportional hazard regression was used to estimate effects of smoke-free years on the time to Expanded Disability Status Scale (EDSS) scores 4.0 and 6.0. MS Impact Scale 29 (MSIS-29) and Patient Determined Disease Steps (PDDS) were used to assess the physical and psychological impact of smoking. Results: Each ‘smoke-free year’ was associated with 0.96 (95% CI: 0.95 to 0.97) times decreased risk of reaching EDSS 4.0 and 0.97 (95%CI: 0.95 to 0.98) times decreased risk of reaching EDSS 6.0. Non-smokers showed a significantly lower level of disability in all the self-reported outcomes compared with current smokers. Conclusion: The reduction in the risk of disability progression after smoking cessation is significant and time-dependent. The earlier the patients quit, the stronger the reduction in the risk of reaching disability milestones. The quantitative estimates of the impact of smoking cessation on reaching disability milestones in MS can be used in interventional trials.
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spelling nottingham-421042018-04-17T15:38:27Z https://eprints.nottingham.ac.uk/42104/ Smoking cessation and the reduction of disability progression in Multiple Sclerosis: a cohort study Tanasescu, Radu Constantinescu, Cris S. Tench, Christopher R. Manouchehrinia, Ali Background: Smoking is associated with a more severe disease course in people with multiple sclerosis (MS). The magnitude of effect of smoking cessation on MS progression is unknown. The aim of this study was to quantify the impact of smoking cessation on reaching MS disability milestones. Methods: This is a cross-sectional study with retrospective reports. A comprehensive smoking questionnaire was sent to 1270 patients with MS registered between 1994 and 2013 in the Nottingham University Hospital MS Clinics database. Demographic and clinical data were extracted from the clinical database. Cox proportional hazard regression was used to estimate effects of smoke-free years on the time to Expanded Disability Status Scale (EDSS) scores 4.0 and 6.0. MS Impact Scale 29 (MSIS-29) and Patient Determined Disease Steps (PDDS) were used to assess the physical and psychological impact of smoking. Results: Each ‘smoke-free year’ was associated with 0.96 (95% CI: 0.95 to 0.97) times decreased risk of reaching EDSS 4.0 and 0.97 (95%CI: 0.95 to 0.98) times decreased risk of reaching EDSS 6.0. Non-smokers showed a significantly lower level of disability in all the self-reported outcomes compared with current smokers. Conclusion: The reduction in the risk of disability progression after smoking cessation is significant and time-dependent. The earlier the patients quit, the stronger the reduction in the risk of reaching disability milestones. The quantitative estimates of the impact of smoking cessation on reaching disability milestones in MS can be used in interventional trials. Oxford University Press 2018-04-02 Article PeerReviewed application/pdf en https://eprints.nottingham.ac.uk/42104/1/Tanasescu%20et%20al%20_Manuscript__cessation%20final.pdf Tanasescu, Radu, Constantinescu, Cris S., Tench, Christopher R. and Manouchehrinia, Ali (2018) Smoking cessation and the reduction of disability progression in Multiple Sclerosis: a cohort study. Nicotine and Tobacco Research, 20 (5). pp. 589-595. ISSN 1469-994X https://academic.oup.com/ntr/article-lookup/doi/10.1093/ntr/ntx084 doi:10.1093/ntr/ntx084 doi:10.1093/ntr/ntx084
spellingShingle Tanasescu, Radu
Constantinescu, Cris S.
Tench, Christopher R.
Manouchehrinia, Ali
Smoking cessation and the reduction of disability progression in Multiple Sclerosis: a cohort study
title Smoking cessation and the reduction of disability progression in Multiple Sclerosis: a cohort study
title_full Smoking cessation and the reduction of disability progression in Multiple Sclerosis: a cohort study
title_fullStr Smoking cessation and the reduction of disability progression in Multiple Sclerosis: a cohort study
title_full_unstemmed Smoking cessation and the reduction of disability progression in Multiple Sclerosis: a cohort study
title_short Smoking cessation and the reduction of disability progression in Multiple Sclerosis: a cohort study
title_sort smoking cessation and the reduction of disability progression in multiple sclerosis: a cohort study
url https://eprints.nottingham.ac.uk/42104/
https://eprints.nottingham.ac.uk/42104/
https://eprints.nottingham.ac.uk/42104/