How Does Smoking Affect Multiple Sclerosis?

How Does Smoking Affect Multiple Sclerosis?

What You Need to Know About MS and Smoking

It is no secret by now that smoking is bad for you.

And guess what? People are taking notice. According to the CDC, current smoking declined from 20.6 percent in 2005 (an estimated 21 out of 100 adults) to 15.5 percent in 2016 (an estimated 15 out of 100 adults).

That being said, smoking is still the leading cause of preventable disease and death in the US – accounting for about 1 in 5 deaths.

If you have multiple sclerosis (MS), you may be wondering how smoking can affect your disease. As it turns out, it can not only affect your chances of developing MS, but it can also affect the progression of your condition. Below, we’ll discuss MS and smoking in greater detail.

The Effects of Smoking and MS

As we will discuss at greater length, it appears that smoking may play a role in the development of MS.

Smoking also appears to be associated with increased disease progression. In the most common form of MS, most patients have relapsing-remitting MS (RRMS). This means that the symptoms come and go.

At some point in time, the disease progresses to secondary progressive MS (SPMS), when symptoms are more consistent, and there is a known deterioration of the brain and spinal cord. Smoking seems to speed up the progression from RRMS to SPMS – up to 3.6 times higher.

Secondhand Smoke and MS

An early 2018 research study published in Multiple Sclerosis Journal indicated that secondhand smoke exposure is a risk factor for adult-onset MS.


The study evaluated secondhand smoke exposure as well as other variables, such as HLA-DRB1*15 alleles, serum 25-hydroxyvitamin D concentrations, and prior exposure to Epstein-Barr virus.

In children with MS, 37 percent had been exposed to secondhand smoke. If secondhand smoke exposure, as well as HLA-DRB1*15 allele, were present, the risk of developing MS increased even more.

Can Smoking and Secondhand Smoke Cause MS?

In a Norwegian study published in Neurology in 2003, researchers found that people who smoked had a significantly higher risk of developing MS than people who had never smoked.

Also, further research indicates that if someone is a smoker and also has been exposed to an Epstein-Barr virus, their risk of developing MS increases substantially as opposed to people without either risk factor, or those with only one risk factor.

Some studies estimate that the risk of developing MS in smokers is approximately 1.5 times higher than that of nonsmokers.

A 2007 French study found that children were twice as likely to develop to get MS if their parents smoked and they were exposed to secondhand smoke – and the longer the exposure, the higher the risk.

Although there are other risk factors for the development of MS, smoking is a modifiable risk factor – not smoking in the first place is ideal, but quitting smoking can reduce the risk of developing MS.

MS and Quitting Smoking

If you think that it is too late to quit smoking because you’ve now been diagnosed with MS, you’re mistaken.

Yes, you may have been diagnosed with a chronic medical condition. However, continuing to smoke each year of smoking can accelerate the progression of MS to SPMS by about 5 percent.

Studies indicate that “People who continued to smoke each year after diagnosis converted to the secondary progressive disease earlier (average age 48) than those who quit smoking (average age 56).”

According to Overcoming MS, many other studies quantify and correlate the link between smoking and MS:

  • A 2003 Norwegian study found that smokers were 1.8 times more likely to develop MS than nonsmokers.
  • A 2005 Harvard study found that people with MS who had previously smoked were 3 to 4 times more likely to develop SPMS than nonsmokers.
  • A 2008 Swedish study of 122 people with MS found that people who were smokers were more likely to advance to progressive disease, and progress earlier.

Remember how we said that smoking is a modifiable risk factor? Well, it is still a modifiable behavior, even after diagnosis.

So, if you’re ready to quit, what can you do? First, the CDC has an excellent smoking cessation resources.

A good way to start your planning using START to begin planning:

  • S: Set a quit date. Choose the date within the next two weeks. This ensures that the timeframe gives you enough time to prepare without losing motivation.
  • T: Tell family, friends, and co-workers when that quit date is. Letting these people know ensures that you’ll receive support and encouragement. Perhaps seek out a “quit buddy” who also would like to quit smoking as well.
  • A: Anticipate the challenges you’ll be facing and begin planning. Statistics show that people start smoking again within the next three months, so planning for challenges ahead of time can prepare you for these challenges.
  • R: Remove cigarettes from your home, car, and workplace. This also includes throwing away lights and ashtrays. Wash your clothes and freshen your home.
  • T: Talk to your doctor about quitting and get help. Discussing your plan with your doctor is important – they can prescribe medications that can increase your chances of success. There are also over-the-counter medications, such as nicotine patches, lozenges, and gum. 

Tips for Managing Cigarette Cravings

The craving for a cigarette is real. Avoiding situations that can bring about these cravings is helpful, but the cravings are going to happen regardless. Fortunately, the desires are generally short-lived and last about 5-10 minutes.

Here are some things that you can do to get you through that craving:

  • Use distraction. Read a book, do the dishes, call a friend, take a walk, do a puzzle. Do anything that will distract you from distract you from the craving.
  • Remind yourself why you quit smoking. Focusing on your “why” can help.
  • Remove yourself from the situation if you are in a tempting situation. For example, if you are having a drink and always have a cigarette when you have a cocktail, maybe it is time to give up that happy hour cocktail – at least temporarily!
  • Reward yourself. When you consistently avoid your cravings, and you quit smoking, it may be time to reward yourself!


CDC (Current Cigarette Smoking Among Adults in the United States)

Multiple Sclerosis News Today (Smoking and MS)

National MS Society (Unhealthy Habits)

Overcoming Multiple Sclerosis (Smoking and MS)

Sage Journals (The Contribution of Secondhand Tobacco Smoke Exposure to Pediatric Multiple Sclerosis Risk)

WebMD (Quitting Smoking May Delay MS Progression)

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by Dr. Donna on September 5, 2014
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