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Smoking and multiple sclerosis (MS)

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When thinking of the health risks of smoking, almost everyone is aware that smoking causes lung cancer and respiratory diseases. The connection between inhaling smoke into the lungs and developing diseases of the lung is immediately plausible. But every year medical researchers discover more and more diseases that are worsened by smoking.

One example that recently caught my attention is multiple sclerosis (MS). MS is a very serious neurological condition caused partly by damage to the myelin sheath covering cells and their connections in the central nervous system. The precise neurological symptoms the person experiences depends largely on which part of their central nervous system is affected.

This is not a disease that is believed to be primarily caused by smoking at all, and in fact the causal and curative mechanisms or not fully understood yet. But even in this disease, the evidence is becoming clearer that tobacco smoking has a serious adverse effect on disease progression.

The most recent study found that people with multiple sclerosis (MS) tend to have more severe brain lesions and atrophy if they ever smoked regularly in their lifetime. According to a new study from the University of Buffalo and SUNY, subjects who had smoked for as little as six months had more impairment than lifelong nonsmokers. Smokers had 17 percent more brain lesions than nonsmokers, less brain volume, and more physical disability.

Dr Robert Zivadinov, (State University of New York) the first author of the study, stated that, cigarette smoking "is one of the most compelling environmental risk factors linked to the development and worsening of MS." This was one of the first studies to document the association between smoking related increases in disability and increased smoking-related brain lesions (as measured by MRI scans).

The study was published in the Aug. 18, 2009 issue of the journal Neurology and the summary can be found at:
http://www.neurology.org/cgi/content/abstract/73/7/504


Another study published in Archives of Neurology in July, 2009 by a group of Boston researchers led by Dr Brian Healy of Mass. General Hospital, concluded that:
“Our data suggest that cigarette smoke has an adverse influence on the progression of MS and accelerates conversion from a relapsing-remitting to a progressive course.”
You can see the summary by cutting and pasting this link:
http://archneur.ama-assn.org/cgi/content/short/66/7/858

Unfortunately, the list of diseases worsened by smoking becomes longer and the associations stronger every year. It is my experience that health professionals specializing in many of these severe illnesses (whether it be lung cancer, HIV or MS) are a bit hesitant in tackling the smoking issue. Often they feel that their patient is already under a lot of stress due to their illness and they are concerned that quitting smoking may be too difficult or add to their stresses. But clearly in the long run this is not in the best interest of patients. At the very least they should be informed very clearly and directly of the general and personal health risks, and offered effective smoking cessation treatment.

But in the mean time, I hope this blog will help smokers with co-occurring illnesses to find out about the additional smoking-caused health risks affecting them, and the methods likely to be effective in helping them quit.

It would be very helpful to hear from people with serious medical illnesses who succeeded in quitting smoking. Other readers may be interested to hear how you did it and may be inspired to give it a try. Please use the “comment” function connected to this blog to post your story.
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About the Author


MA, MAppSci, PhD

Dr. Jonathan Foulds is an expert in the field of tobacco addiction.

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