By Eleanor McDermid, Senior medwireNews Reporter
Patients who are smokers when diagnosed with relapsing–remitting multiple sclerosis (MS) may be able to delay the time to onset of progressive disease by quitting smoking, a study suggests.
“Accordingly, evidence clearly supports advising patients with MS who smoke to quit”, say Jan Hillert (Karolinska Institutet at Karolinska University Hospital Solna, Stockholm, Sweden) and co-researchers in JAMA Neurology.
“Health care services for patients with MS should be organized to support such a lifestyle change.”
Among the patients in the population-based Genes and Environment in Multiple Sclerosis (GEMS) study, the team identified 728 who were regular smokers at the time of MS diagnosis, 118 of whom then quit.
Each successive year that patients continued to smoke after diagnosis was associated with a significant 4.7% acceleration in the time to the development of secondary progressive disease, such that smokers progressed at an average age of 48 years, whereas quitters did not progress until the age of 56 years.
The survival model used included age at diagnosis, which was also significantly associated with time to progressive disease, duration of treatment, which was borderline significant, and gender and snuff use, which did not influence progression.
In a related editorial, Myla Goldman (University of Virginia, Charlottesville, USA) and Olaf Stüve (University of Texas Southwestern Medical Center at Dallas, USA) say that the study “provides the first evidence, to our knowledge, that quitting smoking appears to delay onset of secondary progressive MS and provide protective benefit.”
But they add that an “unexplored question” is whether reducing smoking without stopping entirely could also be beneficial; the researchers defined continuing smokers as anyone smoking at least one cigarette per day, so including a wide range of smoking habits.
“Thus, it remains unclear whether simply cutting back on the amount one is smoking could provide any benefit”, conclude Goldman and Stüve.
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