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The impact of smoking cessation on multiple sclerosis disease progression
Jeff Rodgers,
Tim Friede 
,
Frederick W Vonberg,
Cris S Constantinescu,
Alasdair Coles,
Jeremy Chataway ,
Martin Duddy,
Hedley Emsley,
Helen Ford,
Leonora Fisniku,
Ian Galea ,
Timothy Harrower,
Jeremy Hobart,
Huseyin Huseyin,
Christopher M Kipps,
Monica Marta,
Gavin V McDonnell,
Brendan McLean,
Owen R Pearson,
David Rog,
Klaus Schmierer ,
Basil Sharrack,
Agne Straukiene,
Heather C Wilson,
David Ford ,
Rod Middleton ,
Richard Nicholas
,
Frederick W Vonberg,
Cris S Constantinescu,
Alasdair Coles,
Jeremy Chataway ,
Martin Duddy,
Hedley Emsley,
Helen Ford,
Leonora Fisniku,
Ian Galea ,
Timothy Harrower,
Jeremy Hobart,
Huseyin Huseyin,
Christopher M Kipps,
Monica Marta,
Gavin V McDonnell,
Brendan McLean,
Owen R Pearson,
David Rog,
Klaus Schmierer ,
Basil Sharrack,
Agne Straukiene,
Heather C Wilson,
David Ford ,
Rod Middleton ,
Richard Nicholas
Brain, Volume: 145, Issue: 4, Pages: 1368 - 1378
Swansea University Authors:
Jeff Rodgers, David Ford , Rod Middleton , Richard Nicholas
-
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DOI (Published version): 10.1093/brain/awab385
Abstract
The negative impact of smoking in MS is well established, however, there is much less evidence as to whether smoking cessation is beneficial to progression in MS. Adults with MS registered on the United Kingdom MS Register (2011-2020) formed this retrospective and prospective cohort study. Primary o...
| Published in: | Brain |
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| ISSN: | 0006-8950 1460-2156 |
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Oxford University Press (OUP)
2022
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<?xml version="1.0"?><rfc1807><datestamp>2022-07-08T15:39:38.6300433</datestamp><bib-version>v2</bib-version><id>58437</id><entry>2021-10-20</entry><title>The impact of smoking cessation on multiple sclerosis disease progression</title><swanseaauthors><author><sid>3ee27bde2acae56844ecdcbb563218ac</sid><firstname>Jeff</firstname><surname>Rodgers</surname><name>Jeff Rodgers</name><active>true</active><ethesisStudent>false</ethesisStudent></author><author><sid>52fc0c473b0da1b7218d87f9fc68a3e6</sid><ORCID>0000-0001-6551-721X</ORCID><firstname>David</firstname><surname>Ford</surname><name>David Ford</name><active>true</active><ethesisStudent>false</ethesisStudent></author><author><sid>005518f819ef1a2a13fdf438529bdfcd</sid><ORCID>0000-0002-2130-4420</ORCID><firstname>Rod</firstname><surname>Middleton</surname><name>Rod Middleton</name><active>true</active><ethesisStudent>false</ethesisStudent></author><author><sid>b1b6e8c9f6c79bdd07143f24db58f792</sid><firstname>Richard</firstname><surname>Nicholas</surname><name>Richard Nicholas</name><active>true</active><ethesisStudent>false</ethesisStudent></author></swanseaauthors><date>2021-10-20</date><deptcode>HDAT</deptcode><abstract>The negative impact of smoking in MS is well established, however, there is much less evidence as to whether smoking cessation is beneficial to progression in MS. Adults with MS registered on the United Kingdom MS Register (2011-2020) formed this retrospective and prospective cohort study. Primary outcomes were changes in 3 patient reported outcomes (PROs): normalised MS Physical Impact Scale (MSIS-29-Phys), normalised MS Walking Scale (MSWS-12) and the Hospital Anxiety and Depression Scale (HADS-Anxiety and HADS-Depression). Time to event outcomes were clinically significant increases in the PROs. 7983 participants were included, 4130 (51.7%) of these had ever smoked; of whom 1315 (16.5%) were current smokers and 2815/4130 (68.2%) were former smokers. For all PROs, current smokers at the time of completing their first questionnaire had higher PRO scores indicating higher disability compared to those who had never smoked (∼10 points difference in MSIS-29-Phys and MSWS-12; 1.5-1.8 point for HADS-anxiety and HADS-depression). There was no improvement in PRO scores with increasing time since quitting in former smokers. 923 participants formed the prospective parallel group, which demonstrated that MSIS-29-phy 5.03, [3.71, 6.34], MSWS-12 5.28, [3.62, 6.94] and HADS-depression 0.71, [0.47, 0.96] worsened over a period of 4 years, whereas HADS-anxiety remained stable. Smoking status was significant at year 4; current smokers had higher MSIS-29-Phys and HADS-Anxiety scores (3.05 [0.22, 5.88], 1.14 [0.52,1.76]) while former smokers had a lower MSIS-29 score of -2.91[-5.03, -0.79]. 4642 participants comprised the time to event analysis. Still smoking was associated with a shorter time to worsening event in all PROs (MSIS-29-Phys: n = 4436, p = 0.0013; MSWS-12: n = 3902, p = 0.0061; HADS-anxiety: n = 4511, p = 0.0017; HADS-depression: n = 4511, p &amp;lt; 0.0001). Worsening in motor disability (MSIS-29-Phys and MSWS-12) was independent of baseline HADS-anxiety and HADS-depression scores. There was no statistically significant difference in the rate of worsening between never and former smokers. When smokers quit, there is a slowing in the rate of motor disability deterioration so that it matches the rate of motor decline in those who have never smoked. This suggests that smoking cessation is beneficial for people with MS.</abstract><type>Journal Article</type><journal>Brain</journal><volume>145</volume><journalNumber>4</journalNumber><paginationStart>1368</paginationStart><paginationEnd>1378</paginationEnd><publisher>Oxford University Press (OUP)</publisher><placeOfPublication/><isbnPrint/><isbnElectronic/><issnPrint>0006-8950</issnPrint><issnElectronic>1460-2156</issnElectronic><keywords>multiple sclerosis, public health, epidemiology</keywords><publishedDay>7</publishedDay><publishedMonth>4</publishedMonth><publishedYear>2022</publishedYear><publishedDate>2022-04-07</publishedDate><doi>10.1093/brain/awab385</doi><url/><notes/><college>COLLEGE NANME</college><department>Health Data Science</department><CollegeCode>COLLEGE CODE</CollegeCode><DepartmentCode>HDAT</DepartmentCode><institution>Swansea University</institution><apcterm>SU Library paid the OA fee (TA Institutional Deal)</apcterm><funders>The UK MS Society, The Berkeley Foundation, The Multiple Sclerosis Trials Collaboration</funders><lastEdited>2022-07-08T15:39:38.6300433</lastEdited><Created>2021-10-20T13:41:28.9412662</Created><path><level id="1">Faculty of Medicine, Health and Life Sciences</level><level id="2">Swansea University Medical School - Medicine</level></path><authors><author><firstname>Jeff</firstname><surname>Rodgers</surname><order>1</order></author><author><firstname>Tim</firstname><surname>Friede</surname><orcid>0000-0001-5347-7441</orcid><order>2</order></author><author><firstname>Frederick W</firstname><surname>Vonberg</surname><order>3</order></author><author><firstname>Cris S</firstname><surname>Constantinescu</surname><order>4</order></author><author><firstname>Alasdair</firstname><surname>Coles</surname><order>5</order></author><author><firstname>Jeremy</firstname><surname>Chataway</surname><orcid>0000-0001-7286-6901</orcid><order>6</order></author><author><firstname>Martin</firstname><surname>Duddy</surname><order>7</order></author><author><firstname>Hedley</firstname><surname>Emsley</surname><order>8</order></author><author><firstname>Helen</firstname><surname>Ford</surname><order>9</order></author><author><firstname>Leonora</firstname><surname>Fisniku</surname><order>10</order></author><author><firstname>Ian</firstname><surname>Galea</surname><orcid>0000-0002-1268-5102</orcid><order>11</order></author><author><firstname>Timothy</firstname><surname>Harrower</surname><order>12</order></author><author><firstname>Jeremy</firstname><surname>Hobart</surname><order>13</order></author><author><firstname>Huseyin</firstname><surname>Huseyin</surname><order>14</order></author><author><firstname>Christopher M</firstname><surname>Kipps</surname><order>15</order></author><author><firstname>Monica</firstname><surname>Marta</surname><order>16</order></author><author><firstname>Gavin V</firstname><surname>McDonnell</surname><order>17</order></author><author><firstname>Brendan</firstname><surname>McLean</surname><order>18</order></author><author><firstname>Owen R</firstname><surname>Pearson</surname><order>19</order></author><author><firstname>David</firstname><surname>Rog</surname><order>20</order></author><author><firstname>Klaus</firstname><surname>Schmierer</surname><orcid>0000-0002-9293-8893</orcid><order>21</order></author><author><firstname>Basil</firstname><surname>Sharrack</surname><order>22</order></author><author><firstname>Agne</firstname><surname>Straukiene</surname><order>23</order></author><author><firstname>Heather C</firstname><surname>Wilson</surname><order>24</order></author><author><firstname>David</firstname><surname>Ford</surname><orcid>0000-0001-6551-721X</orcid><order>25</order></author><author><firstname>Rod</firstname><surname>Middleton</surname><orcid>0000-0002-2130-4420</orcid><order>26</order></author><author><firstname>Richard</firstname><surname>Nicholas</surname><order>27</order></author></authors><documents><document><filename>58437__24512__35340344bc4e45c79adeabfea1e4dab7.pdf</filename><originalFilename>58437_VoR.pdf</originalFilename><uploaded>2022-07-08T15:37:47.4038288</uploaded><type>Output</type><contentLength>1020214</contentLength><contentType>application/pdf</contentType><version>Version of Record</version><cronfaStatus>true</cronfaStatus><documentNotes>Copyright: The Author(s) (2021). 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2022-07-08T15:39:38.6300433 v2 58437 2021-10-20 The impact of smoking cessation on multiple sclerosis disease progression 3ee27bde2acae56844ecdcbb563218ac Jeff Rodgers Jeff Rodgers true false 52fc0c473b0da1b7218d87f9fc68a3e6 0000-0001-6551-721X David Ford David Ford true false 005518f819ef1a2a13fdf438529bdfcd 0000-0002-2130-4420 Rod Middleton Rod Middleton true false b1b6e8c9f6c79bdd07143f24db58f792 Richard Nicholas Richard Nicholas true false 2021-10-20 HDAT The negative impact of smoking in MS is well established, however, there is much less evidence as to whether smoking cessation is beneficial to progression in MS. Adults with MS registered on the United Kingdom MS Register (2011-2020) formed this retrospective and prospective cohort study. Primary outcomes were changes in 3 patient reported outcomes (PROs): normalised MS Physical Impact Scale (MSIS-29-Phys), normalised MS Walking Scale (MSWS-12) and the Hospital Anxiety and Depression Scale (HADS-Anxiety and HADS-Depression). Time to event outcomes were clinically significant increases in the PROs. 7983 participants were included, 4130 (51.7%) of these had ever smoked; of whom 1315 (16.5%) were current smokers and 2815/4130 (68.2%) were former smokers. For all PROs, current smokers at the time of completing their first questionnaire had higher PRO scores indicating higher disability compared to those who had never smoked (∼10 points difference in MSIS-29-Phys and MSWS-12; 1.5-1.8 point for HADS-anxiety and HADS-depression). There was no improvement in PRO scores with increasing time since quitting in former smokers. 923 participants formed the prospective parallel group, which demonstrated that MSIS-29-phy 5.03, [3.71, 6.34], MSWS-12 5.28, [3.62, 6.94] and HADS-depression 0.71, [0.47, 0.96] worsened over a period of 4 years, whereas HADS-anxiety remained stable. Smoking status was significant at year 4; current smokers had higher MSIS-29-Phys and HADS-Anxiety scores (3.05 [0.22, 5.88], 1.14 [0.52,1.76]) while former smokers had a lower MSIS-29 score of -2.91[-5.03, -0.79]. 4642 participants comprised the time to event analysis. Still smoking was associated with a shorter time to worsening event in all PROs (MSIS-29-Phys: n = 4436, p = 0.0013; MSWS-12: n = 3902, p = 0.0061; HADS-anxiety: n = 4511, p = 0.0017; HADS-depression: n = 4511, p &lt; 0.0001). Worsening in motor disability (MSIS-29-Phys and MSWS-12) was independent of baseline HADS-anxiety and HADS-depression scores. There was no statistically significant difference in the rate of worsening between never and former smokers. When smokers quit, there is a slowing in the rate of motor disability deterioration so that it matches the rate of motor decline in those who have never smoked. This suggests that smoking cessation is beneficial for people with MS. Journal Article Brain 145 4 1368 1378 Oxford University Press (OUP) 0006-8950 1460-2156 multiple sclerosis, public health, epidemiology 7 4 2022 2022-04-07 10.1093/brain/awab385 COLLEGE NANME Health Data Science COLLEGE CODE HDAT Swansea University SU Library paid the OA fee (TA Institutional Deal) The UK MS Society, The Berkeley Foundation, The Multiple Sclerosis Trials Collaboration 2022-07-08T15:39:38.6300433 2021-10-20T13:41:28.9412662 Faculty of Medicine, Health and Life Sciences Swansea University Medical School - Medicine Jeff Rodgers 1 Tim Friede 0000-0001-5347-7441 2 Frederick W Vonberg 3 Cris S Constantinescu 4 Alasdair Coles 5 Jeremy Chataway 0000-0001-7286-6901 6 Martin Duddy 7 Hedley Emsley 8 Helen Ford 9 Leonora Fisniku 10 Ian Galea 0000-0002-1268-5102 11 Timothy Harrower 12 Jeremy Hobart 13 Huseyin Huseyin 14 Christopher M Kipps 15 Monica Marta 16 Gavin V McDonnell 17 Brendan McLean 18 Owen R Pearson 19 David Rog 20 Klaus Schmierer 0000-0002-9293-8893 21 Basil Sharrack 22 Agne Straukiene 23 Heather C Wilson 24 David Ford 0000-0001-6551-721X 25 Rod Middleton 0000-0002-2130-4420 26 Richard Nicholas 27 58437__24512__35340344bc4e45c79adeabfea1e4dab7.pdf 58437_VoR.pdf 2022-07-08T15:37:47.4038288 Output 1020214 application/pdf Version of Record true Copyright: The Author(s) (2021). This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial License true eng https://creativecommons.org/licenses/ by-nc/4.0/ |
| title |
The impact of smoking cessation on multiple sclerosis disease progression |
| spellingShingle |
The impact of smoking cessation on multiple sclerosis disease progression Jeff Rodgers David Ford Rod Middleton Richard Nicholas |
| title_short |
The impact of smoking cessation on multiple sclerosis disease progression |
| title_full |
The impact of smoking cessation on multiple sclerosis disease progression |
| title_fullStr |
The impact of smoking cessation on multiple sclerosis disease progression |
| title_full_unstemmed |
The impact of smoking cessation on multiple sclerosis disease progression |
| title_sort |
The impact of smoking cessation on multiple sclerosis disease progression |
| author_id_str_mv |
3ee27bde2acae56844ecdcbb563218ac 52fc0c473b0da1b7218d87f9fc68a3e6 005518f819ef1a2a13fdf438529bdfcd b1b6e8c9f6c79bdd07143f24db58f792 |
| author_id_fullname_str_mv |
3ee27bde2acae56844ecdcbb563218ac_***_Jeff Rodgers 52fc0c473b0da1b7218d87f9fc68a3e6_***_David Ford 005518f819ef1a2a13fdf438529bdfcd_***_Rod Middleton b1b6e8c9f6c79bdd07143f24db58f792_***_Richard Nicholas |
| author |
Jeff Rodgers David Ford Rod Middleton Richard Nicholas |
| author2 |
Jeff Rodgers Tim Friede Frederick W Vonberg Cris S Constantinescu Alasdair Coles Jeremy Chataway Martin Duddy Hedley Emsley Helen Ford Leonora Fisniku Ian Galea Timothy Harrower Jeremy Hobart Huseyin Huseyin Christopher M Kipps Monica Marta Gavin V McDonnell Brendan McLean Owen R Pearson David Rog Klaus Schmierer Basil Sharrack Agne Straukiene Heather C Wilson David Ford Rod Middleton Richard Nicholas |
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Brain |
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145 |
| container_issue |
4 |
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1368 |
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2022 |
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Swansea University |
| issn |
0006-8950 1460-2156 |
| doi_str_mv |
10.1093/brain/awab385 |
| publisher |
Oxford University Press (OUP) |
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Faculty of Medicine, Health and Life Sciences |
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facultyofmedicinehealthandlifesciences |
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Faculty of Medicine, Health and Life Sciences |
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facultyofmedicinehealthandlifesciences |
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Faculty of Medicine, Health and Life Sciences |
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Swansea University Medical School - Medicine{{{_:::_}}}Faculty of Medicine, Health and Life Sciences{{{_:::_}}}Swansea University Medical School - Medicine |
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The negative impact of smoking in MS is well established, however, there is much less evidence as to whether smoking cessation is beneficial to progression in MS. Adults with MS registered on the United Kingdom MS Register (2011-2020) formed this retrospective and prospective cohort study. Primary outcomes were changes in 3 patient reported outcomes (PROs): normalised MS Physical Impact Scale (MSIS-29-Phys), normalised MS Walking Scale (MSWS-12) and the Hospital Anxiety and Depression Scale (HADS-Anxiety and HADS-Depression). Time to event outcomes were clinically significant increases in the PROs. 7983 participants were included, 4130 (51.7%) of these had ever smoked; of whom 1315 (16.5%) were current smokers and 2815/4130 (68.2%) were former smokers. For all PROs, current smokers at the time of completing their first questionnaire had higher PRO scores indicating higher disability compared to those who had never smoked (∼10 points difference in MSIS-29-Phys and MSWS-12; 1.5-1.8 point for HADS-anxiety and HADS-depression). There was no improvement in PRO scores with increasing time since quitting in former smokers. 923 participants formed the prospective parallel group, which demonstrated that MSIS-29-phy 5.03, [3.71, 6.34], MSWS-12 5.28, [3.62, 6.94] and HADS-depression 0.71, [0.47, 0.96] worsened over a period of 4 years, whereas HADS-anxiety remained stable. Smoking status was significant at year 4; current smokers had higher MSIS-29-Phys and HADS-Anxiety scores (3.05 [0.22, 5.88], 1.14 [0.52,1.76]) while former smokers had a lower MSIS-29 score of -2.91[-5.03, -0.79]. 4642 participants comprised the time to event analysis. Still smoking was associated with a shorter time to worsening event in all PROs (MSIS-29-Phys: n = 4436, p = 0.0013; MSWS-12: n = 3902, p = 0.0061; HADS-anxiety: n = 4511, p = 0.0017; HADS-depression: n = 4511, p &lt; 0.0001). Worsening in motor disability (MSIS-29-Phys and MSWS-12) was independent of baseline HADS-anxiety and HADS-depression scores. There was no statistically significant difference in the rate of worsening between never and former smokers. When smokers quit, there is a slowing in the rate of motor disability deterioration so that it matches the rate of motor decline in those who have never smoked. This suggests that smoking cessation is beneficial for people with MS. |
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2022-04-07T04:14:58Z |
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1763754008416092160 |
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10.999524 |