Interaction of Alcohol, Smoking on Multiple Sclerosis Severity

A cross-sectional study aimed to assess the effect of smoking and alcohol consumption along with the interactions they have on the clinical course of multiple sclerosis.
The following article is part of conference coverage from the 2018 American Academy of Neurology Annual Meeting in Los Angeles, California. Neurology Advisor’s staff will be reporting breaking news associated with research conducted by leading experts in neurology. Check back for the latest news from AAN 2018.

LOS ANGELES — Smoking on its own is associated with a more severe course of disease, but when combined with alcohol consumption, it leads to a less pronounced increase in Multiple Sclerosis Severity Score (MSSS), according to results of this study were presented at the American Academy of Neurology 2018 Annual Meeting, held April 21 to 27, 2018, here in Los Angeles, California.

Investigators recruited patients with multiple sclerosis (MS) at the Novara Hospital in Italy from 2009 to 2012. The European Prospective Investigation Into Cancer and Nutrition lifestyle questionnaire was used to evaluate smoking and alcohol history, and the MSSS was used to assess MS severity. The upper vs lower tertiles of the MSSS were compared using the estimated age- and sex-adjusted logistic regression models.

There were 351 participants in the MS patient group, including 190 ever-smokers and 283 ever-drinkers. Compared with never-smokers, ever-smokers were almost 2 times more likely to fall into the upper tertile (P =.024). The subgroup of ever-smokers/never-drinkers was 6 times more likely to fall in the upper MSSS tertile than the subgroup of never-smokers/never-drinkers (P =.013). 

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The lowest MSSS was in patients who never drank and never smoked (MSSS median, 1.0), and the highest severity was in patients who smoked but never drank (MSSS median, 6.3). The severity scores were intermediate in patients who only drank (MSSS median, 1.6), or who both drank and smoked (MSSS median, 2.4; P for trend <.001). According to the number of drinks per year, alcohol use was categorized as either a high or low drink load, confirming the trend (P for trend <.001).

In conclusion, this study found that “cigarette smoking only is associated with more severe disease course, but in combination with alcohol consumption tends to be less pronounced increasing MSSS level.”

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Ivashynka A, Arcuti S, Vecchio D, et al. Interaction of alcohol consumption and smoking on multiple sclerosis severity course: a cross-sectional study. Presented at: American Academy of Neurology 2018 Annual Meeting; April 21-27, 2018; Los Angeles, CA. Abstract 139.