Smoking Causes Worsened Functioning, Respiratory Problems in Patients With MS


Patients with multiple sclerosis who smoked cigarettes had higher rates of respiratory complications and increased sedentary lifestyle.

Smoking cigarettes further exacerbates respiratory complications and increases sedentary lifestyle in patients with multiple sclerosis (MS), according to a new study published in Multiple Sclerosis and Related Disorders.

Cigarette smoke, with its highly reactive oxidative molecules, can cause inflammatory damage. Apart from heightening the risk of cancer, smoking cigarettes has also been tied to triggering several inflammatory diseases, such as rheumatoid arthritis. In previous studies, environmental factors such as exposure to cigarette smoke has been linked to higher incidence of MS and have indicated that smoking can lead to faster disease progression.

In the study, researchers examined the effects of cigarette smoking on the functional levels of patients with MS. They focused on respiratory symptoms such as dyspnea (shortness of breath), cough, sputum, and fatigue. They also evaluated aspects such as distance walked daily, average sitting time, and total time with no activity to measure the level of sedentary lifestyle.

In total, 135 patients with MS received a questionnaire on cigarette use. All respondents had to be self-sufficient and able to walk without help for at least 12 hours per day. The researchers determined disability using the Expanded Disability Status Scale (EDSS) score (0 to 10). Dyspnea was measured with the Modified Medical Research Council (mMRC) Dyspnea Scale. The researchers also assessed severity of dyspnea and perceptions of fatigue during rest and effort, as well as respiratory symptoms in patients requiring hospitalization in the 6 months preceding the study.

Patients who smoked cigarettes had higher rates of cough (67%), sputum (69%), and hospital admission due to respiratory complaints (29%), as well as increased dyspnea and fatigue during effort compared with non-smokers. Additionally, smokers had a lower mean daily walked distance than non-smokers and higher levels of sedentary life, according to the study.

The researchers determined that the number of cigarettes smoked was associated with lower distance walked and greater fatigue, effort, and resting dyspnea, cough, sputum, hospitalization, and sedentary levels.

Overall, the mean EDSS score was 2.85 in smokers and 2.96 in non-smokers, which is not statistically different.

Further studies with more patients should be conducted to continue to assess the effects of cigarette smoking on MS progression, according to the researchers.

“It has been proven that smoking increases respiratory problems, even in MS patients with a good EDSS score,” the researchers concluded in the study. “Moreover, these problems lead to a further reduction in the functional levels of patients, in addition to disease progression.”


Aktan R, Ozalevli S, Ozakbas S. Effects of cigarette smoking on respiratory problems and functional levels in multiple sclerosis patients. Multiple Sclerosis and Related Disorders. 2018. Doi:

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