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September 2019
General health

The impact of lifetime alcohol and cigarette smoking loads on multiple sclerosis severity

The association between lifestyle factors and Multiple Sclerosis (MS) disease severity and progression has been investigated to a lesser extent compared with susceptibility to the disease. A research team assessed the impact of lifetime alcohol and cigarette smoking load on MS severity.
The cross-sectional study included 351 patients consecutively admitted to the Department of Neurology, who were asked to complete the “Questionnaire of Lifestyle” (part of the European Prospective Investigation into Cancer and Nutrition project). An estimation of the cumulative lifetime cigarette smoking and alcohol load was calculated as the weighted sum of the mean number of cigarettes smoked and standard alcoholic drinks consumed per day at different ages. Disease severity was estimated by the Multiple Sclerosis Severity Score (MSSS).
The median MSSS was higher (3.2 vs. 2.3, p = 0.002) in ever- vs. never-smokers, but no difference was found between ever- and never-drinkers (2.7 vs. 2.8, p = ns). Ever-smokers were almost twice as
likely to fall in the upper MSSS tertile than never- smokers. Ever-drinkers did not show a statistically significant association between alcohol intake and MS severity. The risk of falling in the worst MSSS tertile for smokers was 10.81 (2.0-58.48; p < 0.01) if they were never-drinkers, whereas it was only 1.65 (0.89-3.03, p = 0.11) if they were also drinkers. The risk of falling in the worst MSSS tertile for drinkers did not change as much, whether they also were smokers (0.46; 0.13-1.65; p = 0.23) or not (1.49;
0.55-4.04, p = 0.43) however.
The researchers conclude that cigarette smoking, unlike alcohol consumption, is associated with MS severity. Alcohol consumption may attenuate the effect of smoking on disease severity, acting as an effect modifier. The biological background of this effect is unknown.
Source: The Impact of lifetime alcohol and cigarette smoking loads on multiple sclerosis severity. Ivashynka A, Copetti M, Naldi P4 D’Alfonso S, Leone MA. Front Neurol. 2019 Aug 13;10:866.
doi.org/10.3389/fneur.2019.00866
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