Cigarette smoking may lead to increased respiratory problems and decreased functional levels in patients with multiple sclerosis (MS), according to findings published in Multiple Sclerosis and Related Disorders.

Participants in the study were smokers (n=68) and non-smokers (n=67) diagnosed with MS. All participants were self-reliant and capable of walking without help for about 12 hours per day. Investigators determined an Expanded Disability Status Scale (EDSS) score for each participant based on their most recent neurological exam.

Investigators collected additional data in a questionnaire e-mailed to participants. Participants provided average daily walking distance, average daily sitting time, and average daily time without activity. They recorded shortness of breath using the Modified Medical Research Council (mMRC) Dyspnea Scale and perceived effort and resting dyspnea using the modified Borg (mBORG) scale. Investigators quantified cigarette consumption in pack-years, the number of years a participant had been smoking and the number of packs of cigarettes that participant smoked daily.

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The smoker group exhibited higher rates of cough (67%, P =.04) and sputum (69%, P=.01) symptoms as well as higher rates of admission to the hospital (29%, P =.01) due to respiratory complaints than the non-smoker group. In addition, the mean daily walking distance for the smoker group was lower than that of the non-smoker group. The smoker group also reported a high level of sedentary lifestyle, and non-smokers reported a low level of sedentary lifestyle.

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Investigators identified positive correlations between cigarette consumption and shortness of breath (r=.33, P =.01), perceived effort and resting dyspnea (r=.36, P < .001 and r=.28, P =.02 respectively), sedentary lifestyle (r=.28, P =.02), cough (r=.38, P<.001), sputum (r=.36, P <.001), and admission to the hospital because of respiratory complaints (r=.23, P =.06).

Based on the results of this study, cigarette consumption promotes disease progression in patients with MS. Physicians should educate patients with MS about the possible effects of cigarette smoking and encourage them to quit smoking immediately. Recent studies have shown that highly reactive oxidative species present in cigarette smoke are involved in the processes that promote neurological disease progression. However, further research is necessary to understand the extent to which and the mechanism by which cigarette consumption affects disease progression in patients with MS.


Aktan R, Ozalevli S, Ozakbas S. Effects of cigarette smoking on respiratory problems and functional levels in multiple sclerosis patients [published online August 17, 2018]. Mult Scler Relat Disord. doi: 10.1016/j.msard.2018.08.016.

This article originally appeared on Neurology Advisor