Smokers with MS have greater decrements in quality of life and disability than non-smokers

Abstract

Background:

Tobacco smoke plays a pathogenic role in multiple sclerosis (MS) and may accelerate disease progression, yet, some people with MS continue to smoke after disease onset. The average smoker reports diminished health-related quality of life (HRQOL) across many populations.

Objectives:

To describe the relationships between smoking status and HRQOL, disease activity, and global disability in a US population with MS.

Methods:

We compared smokers to non-smokers in 950 responders to the Spring 2014 update survey completed by North American Research Committee on Multiple Sclerosis (NARCOMS) registry participants. HRQOL was assessed using Short Form-12 version 2 (SF-12v2), disease activity was investigated using eight Performance Scales (PS) and three Functionality Scales (FS). Global disability was evaluated using Patient Determined Disease Steps (PDDS) and an item response theory (IRT) summed score based on the PS and FS.

Results:

Smokers had lower HRQOL (p < 0.0001), reported more disease activity (p < 0.05) and greater deficits in all PS and FS (p = 6 × 10⁻⁷ to 0.05), except mobility. Smokers and non-smokers did not differ by PDDS but had substantially greater IRT global disability (p = 2 × 10⁻⁷).

Conclusion:

Active smoking is meaningfully associated with deficits across multiple domains in people with MS and adds to the growing literature of the need for MS-tailored smoking cessation programs.

Keywords

Multiple sclerosis smoking item response theory disability quality of life

Get full access to this article

View all access options for this article.

References

National Institute of Neurological Disorders and Stroke, http://www.ninds.nih.gov/disorders/multiple_sclerosis/detail_multiple_sclerosis.htm

Confavreux

Vukusic

Moreau

et al . Relapses and progression of disability in multiple sclerosis. N Engl J Med 2000; 343: 1430–1438.

Mitchell

Benito-Leon

Gonzalez

et al . Quality of life and its assessment in multiple sclerosis: Integrating physical and psychological components of wellbeing. Lancet Neurol 2005; 4: 556–566.

Casetta

Riise

Wamme Nortvedt

et al . Gender differences in health-related quality of life in multiple sclerosis. Mult Scler 2009; 15: 1339–1346.

Goldenberg

Danovitch

IsHak

WW.

Quality of life and smoking. Am J Addict 2014; 23: 540–562.

Poorolajal

Bahrami

Karami

et al . Effect of smoking on multiple sclerosis: A meta-analysis. J Public Health. Epub ahead of print 8 May 2016. DOI: 10.1093/pubmed/fdw030.

Ramanujam

Hedstrom

Manouchehrinia

et al . Effect of smoking cessation on multiple sclerosis prognosis. JAMA Neurol 2015; 72: 1117–1123.

Marrie

Horwitz

Cutter

et al . High frequency of adverse health behaviors in multiple sclerosis. Mult Scler 2009; 15: 105–113.

Friend

Mernoff

Block

et al . Smoking rates and smoking cessation among individuals with multiple sclerosis. Disabil Rehabil 2006; 28: 1135–1141.

10.

Cioncoloni

Innocenti

Bartalini

et al . Individual factors enhance poor health-related quality of life outcome in multiple sclerosis patients. Significance of predictive determinants. J Neurol Sci 2014; 345: 213–219.

11.

Weiland

Hadgkiss

Jelinek

et al . The association of alcohol consumption and smoking with quality of life, disability and disease activity in an international sample of people with multiple sclerosis. J Neurol Sci 2014; 336: 211–219.

12.

Jawahar

Eaton

et al . Association between smoking and health outcomes in postmenopausal women living with multiple sclerosis. Mult Scler Int 2014; 2014: 686045.

13.

Ware

Kosinski

Turner-Bowker

et al . SF-12v2: How to score version 2 of the SF-12 health survey. Lincoln, RI: QualityMetric Incorporated, 2005.

14.

Schwartz

Vollmer

Lee

. Reliability and validity of two self-report measures of impairment and disability for MS. North American Research Consortium on Multiple Sclerosis Outcomes Study Group. Neurology 1999; 52: 63–70.

15.

Chamot

Kister

Cutter

GR.

Item response theory-based measure of global disability in multiple sclerosis derived from the Performance Scales and related items. BMC Neurol 2014; 14: 192.

16.

Learmonth

Motl

Sandroff

et al . Validation of patient determined disease steps (PDDS) scale scores in persons with multiple sclerosis. BMC Neurol 2013; 13: 37.

17.

Marrie

Cutter

Tyry

et al . Validation of the NARCOMS registry: Diagnosis. Mult Scler 2007; 13: 770–775.

18.

Marrie

Goldman

Validity of performance scales for disability assessment in multiple sclerosis. Mult Scler 2007; 13: 1176–1182.

19.

Schwartz

Sprangers

Oort

et al . Response shift in patients with multiple sclerosis: An application of three statistical techniques. Qual Life Res 2011; 20: 1561–1572.

20.

Marrie

Cutter

Tyry

et al . Validation of the NARCOMS registry: Fatigue assessment. Mult Scler 2005; 11: 583–584.

21.

Marrie

Cutter

Tyry

et al . Validation of the NARCOMS registry: Pain assessment. Mult Scler 2005; 11: 338–342.

22.

Freeman

Hobart

Langdon

et al . Clinical appropriateness: A key factor in outcome measure selection: The 36 item short form health survey in multiple sclerosis. J Neurol Neurosurg Psychiatry 2000; 68: 150–156.

23.

Cella

Yount

Rothrock

et al . The Patient-Reported Outcomes Measurement Information System (PROMIS): Progress of an NIH roadmap cooperative group during its first two years. Med Care 2007; 45: S3–S11.

24.

Chamot

Kister

Cutter

GR.

Bifactor structure of clinical disability in relapsing multiple sclerosis. Mult Scler Relat Disord 2014; 3: 176–185.

25.

National Multiple Sclerosis Society, http://www.nationalmssociety.org/What-is-MS

26.

Jamal

Homa

O’Connor

et al . Current cigarette smoking among adults—United States, 2005–2014. MMWR Morb Mortal Wkly Rep 2015; 64: 1233–1240.

27.

Turner

Kivlahan

Kazis

et al . Smoking among veterans with multiple sclerosis: Prevalence correlates, quit attempts, and unmet need for services. Arch Phys Med Rehabil 2007; 88: 1394–1399.

28.

Pittas

Ponsonby

van der Mei

et al . Smoking is associated with progressive disease course and increased progression in clinical disability in a prospective cohort of people with multiple sclerosis. J Neurol 2009; 256: 577–585.

29.

Sena

Couderc

Ferret-Sena

et al . Apolipoprotein E polymorphism interacts with cigarette smoking in progression of multiple sclerosis. Eur J Neurol 2009; 16: 832–837.

30.

Horakova

Zivadinov

Weinstock-Guttman

et al . Environmental factors associated with disease progression after the first demyelinating event: Results from the multi-center SET study. PLoS ONE 2013; 8: e53996.

31.

Gunzler

Perzynski

Morris

et al . Disentangling Multiple Sclerosis and depression: An adjusted depression screening score for patient-centered care. J Behav Med 2015; 38: 237–250.

32.

Meyer-Moock

Feng

Maeurer

et al . Systematic literature review and validity evaluation of the Expanded Disability Status Scale (EDSS) and the Multiple Sclerosis Functional Composite (MSFC) in patients with multiple sclerosis. BMC Neurol 2014; 14: 58.

33.

Koch

van Harten

Uyttenboogaart

et al . Cigarette smoking and progression in multiple sclerosis. Neurology 2007; 69: 1515–1520.

34.

Manouchehrinia

Tench

Maxted

et al . Tobacco smoking and disability progression in multiple sclerosis: United Kingdom cohort study. Brain 2013; 136: 2298–2304.

35.

Correale

Farez

MF.

Smoking worsens multiple sclerosis prognosis: Two different pathways are involved. J Neuroimmunol 2015; 281: 23–34.

Supplementary Material

Please find the following supplemental material available below.

For Open Access articles published under a Creative Commons License, all supplemental material carries the same license as the article it is associated with.

For non-Open Access articles published, all supplemental material carries a non-exclusive license, and permission requests for re-use of supplemental material or any part of supplemental material shall be sent directly to the copyright owner as specified in the copyright notice associated with the article.

0.00 MB

0.26 MB