Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2014 Oct;85(10):1091-5.
doi: 10.1136/jnnp-2013-307187. Epub 2014 Feb 25.

Tobacco smoking and excess mortality in multiple sclerosis: a cohort study

Ali Manouchehrinia  1 , Mikail Weston  1 , Christopher R Tench  1 , John Britton  2 , Cris S Constantinescu  1
Affiliations
Free PMC article

Tobacco smoking and excess mortality in multiple sclerosis: a cohort study

Ali Manouchehrinia et al. J Neurol Neurosurg Psychiatry. 2014 Oct.
Free PMC article

Abstract

Objective: As patients with multiple sclerosis (MS) have more than 2.5-fold increased mortality risk, we sought to investigate the impact of tobacco smoking on the risk of premature death and its contribution to the excess mortality in MS patients.

Methods: We studied 1032 patients during the period 1994-2013 in a UK-based register. Cox regression model was used to investigate the impact of smoking on the risk of premature death, controlling for confounders. Smoking-specific mortality rates were compared with the UK general population.

Results: Of 923 patients with clinically definite MS, 80 (46 males and 34 females) had died by December 2012. HRs for death in current smokers and ex-smokers relative to never smokers were 2.70 (95% CI 1.59 to 4.58, p<0.001) and 1.30 (95% CI 0.72 to 2.32; p = 0.37). The standardised mortality ratio, compared with the UK general population, when stratified by smoking status was 3.83 (95% CI 2.71 to 5.42) in current smokers, 1.96 (95% CI 1.27 to 3.0) in ex-smokers and 1.27 (95% CI 0.87 to 1.86) in non-smokers. Never smokers and ex-smokers with MS had similar mortality rates compared with never smokers and ex-smokers without MS in the male British doctors cohort (1.12 (95% CI 0.63 to 1.97) and 0.54 (95% CI 0.26 to 1.14), respectively), while current smokers with MS had 84% higher rate of death compared with current smokers without MS (95% CI 1.24 to 2.72).

Conclusions: Tobacco smoking can account for some of the excess mortality associated with MS and is a risk determinant for all-cause and MS-related death.

Keywords: MULTIPLE SCLEROSIS.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Cox proportional hazard regression graph showing survival from birth (A) by lifelong smoking status and (B) latest smoking status.
See this image and copyright information in PMC

References

    1. Bronnum-Hansen H, Koch-Henriksen N, Stenager E. Trends in survival and cause of death in Danish patients with multiple sclerosis. Brain 2004;127(Pt 4):844–50 - PubMed
    1. Sadovnick AD, Ebers GC, Wilson RW, et al. Life expectancy in patients attending multiple sclerosis clinics. Neurology 1992;42:991–4 - PubMed
    1. Kingwell E, van der Kop M, Zhao Y, et al. Relative mortality and survival in multiple sclerosis: findings from British Columbia, Canada. J Neurol Neurosurg Psychiatry 2012;83:61–6 - PubMed
    1. Scalfari A, Knappertz V, Cutter G, et al. Mortality in patients with multiple sclerosis. Neurology 2013;81:184–92 - PMC - PubMed
    1. WHO. WHO report on the global tobacco epidemic: warning about the dangers of tobacco. 2011

Publication types