MSer's not boozers or smokers

[SuzE-Q]

Maybe it's not the smoking after all...

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Arq Neuropsiquiatr. 2015 Aug 18:0. [Epub ahead of print]

Patients with multiple sclerosis do not necessarily consume more alcohol or tobacco than the general population.

Fragoso YD1, Gomes S2, Goncalves MV3, Machado SC4, Morales RR5, Oliveira FT2, Oliveira JF6, Olmo NR1, Parolin MK7, Siquineli F6, Stoney PN8.

Abstract
Purpose Recent papers suggest that patients with multiple sclerosis (MS) are prone to alcohol misuse. This may be due to the combination of a lifelong and disabling disease with a psychiatric profile typical of MS. The objective of the present study was to assess these findings in a culturally different population of patients with MS.

Method The present case-control transversal study assessed 168 patients with MS and 168 control subjects from Brazil.

Results There were no evidence that patients with MS drank more alcohol or, smoked more than did controls. In fact, control subjects had a significantly higher alcohol consumption. The only trait associated to higher alcohol consumption was anxiety, both for patients and controls.

Conclusion Unlike previous reports in the literature, patients with MS in our study did not drink or smoked more than a control population.

PMID: 26291989 [PubMed - as supplied by publisher]

[Lazarus]

Thanks! Good point to the study. It links in to the modern pseudoscience that looks for things a disabled person did to "invite illness into their bodies".

Many of my friends don't do any drinking because it makes us so uncomfortable. Too much fog!

[Virginia]

I agree too much fog, but also it may not mix with other drugs and both alcohol and cigarettes can be expensive. Some people with MS cannot afford to put out too much extra money if they have had to leave work early.

[SalpalSally]

I don't drink or smoke anymore. I am so tired though of them blaming smoking and drinking for all of our diseases. Not that it doesn't cause illness in some people, but it's impossible to point to it being the only cause for a specific disease.

Does that make since? lol

[agate]

Smoking or drinking alcohol can't cause MS. I never smoked or drank beyond a couple of attempts at it in my late teens-early 20s. Many people who have MS haven't ever smoked or had alcoholic drinks, not even beer.

I think there's general agreement that smoking makes MS symptoms worse and probably speeds the disease process along as well but the facts aren't in on drinking. There's been occasional evidence that alcohol might even help, and I knew one person with MS whose neuro, who happened to be the most highly respected and popular neuro in town, advised him to drink beer every day.

I've been keeping an eye on MS research for years. I'm no expert and have no medical training but I like to know what topics are getting attention. The effect of smoking has been a popular topic in recent years.

[SuzE-Q]

I don't drink or smoke anymore. I am so tired though of them blaming smoking and drinking for all of our diseases. Not that it doesn't cause illness in some people, but it's impossible to point to it being the only cause for a specific disease.

Does that make since? lol

Sure, Sal, you want the pole in your bedroom because you're still a party animal. We know.

[Cat Dancer]

There is a ton of evidence that smoking causes many of the cases of lung cancer. But I do know at least 2 people who died of lung cancer that never smoked. As for having anything to do with MS....I stopped drinking almost entirely because I had/have enough balance issues, dizziness issues, just from the MS and some MS related meds I'm taking, even one drink can lay me flat! Not a pretty sight! Now, occasionally, I'll have a glass of wine or a beer, but then come home and immediately crash into bed.

I never smoked...well, not exactly true. Bought a pack of cigs when I went off to college. Smoked 2-3 of them...couldn't believe how NASTY they tasted! Threw the pack away, never smoked again.

[jendie]

I've never been a smoker and shortly after I was first dx, it was determined that drinking alcohol improved my walking... but that was 17 yrs ago and my walking has gotten worse since I stopped getting Novantrone infusions in 2006, with or without alcohol.

[agate]

Well, now there's been a study that seems to show that stopping smoking after an MS diagnosis might delay progression to secondary MS. The journal JAMA Neurology (September 8) has an article about it as well as an editorial about the article, and one of the authors of the editorial is Olaf Stuve, who must be pretty well known in MS research because even I have heard of him.

The first part of the editorial, which has the title "Smoking beyond Multiple Sclerosis Diagnosis: A Risk Factor Worth Modifying":


Quote

Multiple sclerosis (MS) is a posited autoimmune disorder of the central nervous system with both inflammatory and degenerative features. Despite the rapidly expanding therapeutic repertoire for relapsing MS, we remain limited in our ability to alter the progressive course of MS. Indeed, results of therapeutic trials in progressive MS disease have, to date, been disappointingly negative. On December 1, 2014, a negative study of fingolimod in primary progressive MS again reinforced our inability to alter the course of progressive disease.The next anticipated results are from a study of natalizumab in secondary progressive MS, due in fall 2015.

Abstract of the article:
Quote

Effect of Smoking Cessation on Multiple Sclerosis Prognosis

Ryan Ramanujam, PhD; Anna-Karin Hedström, MD; Ali Manouchehrinia, PhD; Lars Alfredsson, PhD; Tomas Olsson, MD, PhD; Matteo Bottai, PhD; Jan Hillert, MD, PhD


Author Affiliations [omitted]



Importance

Smoking tobacco is a well-established risk factor for multiple sclerosis (MS), a chronic inflammatory disorder of the central nervous system usually characterized by bouts and remissions and typically followed by a secondary progressive (SP) course. However, it is not clear whether smoking after diagnosis is detrimental.

Objective

To determine whether smoking after MS diagnosis is associated with a change in time to SP disease.

Design, Setting, and Participants

Cross-sectional study of patients with prevalent MS who smoked at diagnosis (n = 728) taken from the Genes and Environment in Multiple Sclerosis Study, which consists of patients from the Swedish National MS Registry. The study entrance date was at time of first-year smoking. The study was conducted between November 2008 and December 2011, with patient environmental data collected from November 2009 to March 2011 via questionnaire. Study participants were from all counties in Sweden diagnosed as having MS at the time of the Genes and Environment in Multiple Sclerosis Study and registered in the Swedish National MS Registry. Patients with MS with relapsing-remitting disease course or SP were included. These patients’ conditions were diagnosed according to the McDonald criteria and the patients responded to recruitment letters with detailed questionnaires.

Exposure

Smoking, considered yearly after diagnosis and combined into a time-invariant covariate before diagnosis.

Main Outcomes and Measures

Time to SPMS, measured using an accelerated failure time model, with smoking as a time-varying covariate. Other covariates included sex, age at diagnosis, snuff use, and smoking before diagnosis.

Results

The optimized model illustrated that each additional year of smoking after diagnosis accelerated the time to conversion to SPMS by 4.7% (acceleration factor, 1.047; 95% CI, 1.023-1.072; P < .001). Kaplan-Meier plots demonstrated that those who continued to smoke continuously each year after diagnosis converted to SPMS faster than those who quit smoking, reaching SP disease at 48 and 56 years of age, respectively.

Conclusions and Relevance

This study provides evidence that continued smoking is associated with an acceleration in time to SPMS and that those who quit fare better. Therefore, we propose that patients with MS should be advised to stop smoking once a diagnosis has been made, not only to lessen risks for comorbidities, but also to avoid aggravating MS-related disability.

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[SuzE-Q]

Results

The optimized model illustrated that each additional year of smoking after diagnosis accelerated the time to conversion to SPMS by 4.7% (acceleration factor, 1.047; 95% CI, 1.023-1.072; P < .001). Kaplan-Meier plots demonstrated that those who continued to smoke continuously each year after diagnosis converted to SPMS faster than those who quit smoking, reaching SP disease at 48 and 56 years of age, respectively.

Conclusions and Relevance

This study provides evidence that continued smoking is associated with an acceleration in time to SPMS and that those who quit fare better. Therefore, we propose that patients with MS should be advised to stop smoking once a diagnosis has been made, not only to lessen risks for comorbidities, but also to avoid aggravating MS-related disability.

I was just coming here to post this, thanks for posting, agate!

Quite a dramatic impact on time to MS conversion! Something smokers need to seriously take into consideration.

[SalpalSally]

To late for me, Didn't stop smoking till after I was SPMS. Probably wouldn't have believed it back then, anyway. I was a happy smoker....Stupid!!!!

[agate]

Sally, although this wasn't the topic of the study, there have been other studies--many of them--showing that stopping smoking at any age is always beneficial. The harm done by smoking is often reversible.

If it's any comfort to you, your MS might be much worse at this point if you'd kept on smoking.

I'll get off this soapbox now. There's just too much evidence against this habit though I do think that our society has been pretty harsh on those who are still smoking. Many are trying to quit and haven't got there yet. A few are defiantly going on smoking and not caring what it does to them.

[agate]

I agree too much fog, but also it may not mix with other drugs and both alcohol and cigarettes can be expensive. Some people with MS cannot afford to put out too much extra money if they have had to leave work early.

Virginia, that is so true. The economic cost of MS to the person who has MS as well as to that person's family can be huge. There's often no room in the budget for extras.

[Gary]

If it wasn't for my e-cig I would still be smoking. I do like a scotch and soda from time to time and I like to brew beer. I am working on a hard root beer at the moment. Thinking about actually selling it as well. After we owned a bar drinking isn't as fun as it used to be!

[Howie]

Gary, you can get the e-cig cartridges with nicotine in them. Do you use the ones that are just water vapor, or the nicotine ones?