International Journal of Clinical and Experimental Neurology
ISSN (Print): 2379-7789 ISSN (Online): 2379-7797 Website: Editor-in-chief: Zhiyou Cai, MD
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International Journal of Clinical and Experimental Neurology. 2020, 8(1), 9-13
DOI: 10.12691/ijcen-8-1-3
Open AccessArticle

The Role of Smoking on Patient with Multiple Sclerosis, Three Cases from Vlora City

Evis Allushi1, , Gentian Vyshka2 and Vasilika Prifti1

1University Ismail Qemali, Department of Nursing, Vlore Albania

2University of Tirana Medicine Faculty, Tirana, Albania

Pub. Date: November 30, 2020

Cite this paper:
Evis Allushi, Gentian Vyshka and Vasilika Prifti. The Role of Smoking on Patient with Multiple Sclerosis, Three Cases from Vlora City. International Journal of Clinical and Experimental Neurology. 2020; 8(1):9-13. doi: 10.12691/ijcen-8-1-3


Multiple Sclerosis (MS) is a chronic, inflammatory disorder of the central nervous system (CNS) with presumed autoimmune etiology. Lifestyle changes such as quitting smoking or reducing smoking doses, alcoholabstinence and maintaininghealthy weight are important for treatment success. Smoking has negative effect on MS patients, by worsening symptoms, creating more relapses and making it harder to treat the disease. Smoking MS patients that quit, may improve their condition. Method and materials: this study is performed in the hospital of Vlore during 2019 and we interviewed three MS hospitalized patients. We used 15 questions interview to get the patients opinion and information. They voluntarily participated in this study. Results: We interviewed three patients, from whom two smoked and one never did. The condition of the patients who smoked clearly became worse from the smoking, while the patient who did not smoke had a better prognosis by keeping the condition stable. One of the patients who smoked had quit two years ago. The three patients were aware of the negative effects that smoking had on their condition. Conclusions: Life quality of two of our patients changed when one of them started smoking and when one quit, the third keeps on deteriorating. In Albania there is an undisputable need to conduct such studies in order to follow up patients with MS, their smoking and the effect that it has on the progress of the disease.

MS smoking disease progress

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[1]  Alastair Compston, FRCP, Dr Alasdair Coles, FRCP. Multiple sclerosis. 2008; 25(October).
[2]  Prof Alastair Compston, FRCP, Alasdair Coles, MRCP Multiple sclerosis. 2002; 06(April).
[3]  Jack S Burks 1, George Kim Bigley, Harry Haydon Hill. Rehabilitation challenges in multiple sclerosis. Ann Indian Acad Neurol. 2009; (October): 4.
[4]  Public Health England. Multiple sclerosis: prevalence, incidence and smoking status - data briefing. prevalence-incidence-and-smoking-status Published February 2020. Accessed July 17, 2020.
[5]  P Sundström 1, L Nyström. Smoking worsens the prognosis in multiple sclerosis Epub 2008; 16(July).
[6]  Centers for Disease Control and Prevention. Chemicals in Tobacco Smoke. ooklet/chemicals_smoke/index.htm. Published March 21, 2011. Accessed September 1, 2020.
[7]  Feifei Qiu, Chun-Ling Liang, Huazhen Liu, Yu-Qun Zeng, Shaozhen Hou,Song Huang, et. al. Impacts of cigarette smoking on immune responsiveness: Up and down or upside down? Oncotarget. 2017;8(1): 268-284.
[8]  Simon K.C., van der Mei I.A., Munger K.L., Ponsonby A., Dickinson J., Dwyer T., et al. Combined effects of smoking, anti-EBNA antibodies, and HLA-DRB1*1501 on multiple sclerosis risk. Neurology. 2010:27(April): 74.
[9]  P Sundström 1, L Nyström, G Hallmans. Smoke exposure increases the risk for multiple sclerosis. Eur J Neurol. 2008; 15(January): 6.
[10]  Mattia Rosso, Tanuja Chitnis. Association Between Cigarette Smoking and Multiple Sclerosis: A Review. JAMA Neurol. 2019; 16(December).
[11]  A K Hedström, M Bäärnhielm, T Olsson, L Alfredsson. Exposure to environmental tobacco smoke is associated with increased risk for multiple sclerosis. Mult Scler. 2011; 17(July): 7.
[12]  Cleveland clinic, Neurological Institute. Multiple Sclerosis & Smoking. tiple-sclerosis/ms-approaches/ms-and-smoking. Published 2008. Accessed September 1, 2020.
[13]  Van der Vuurst de Vries RM, Mescheriakova JY, Runia TF, et al. Smoking at time of CIS increases the risk of clinically definite multiple sclerosis. J Neurol. 2018; 20(February).
[14]  Petersen ER, Søndergaard HB, Laursen JH, et al. Smoking is associated with increased disease activity during natalizumab treatment in multiple sclerosis. MultScler. 2019; 25(September).
[15]  Ali Manouchehrinia, Tobacco Smoking and Disability Progression in Multiple Sclerosis: United Kingdom Cohort Study. Epub. 2013 11(July).
[16]  Jalal Poorolajal, Masoud Bahrami, Manoochehr Karami, Elham Hooshmand. Effect of smoking on multiple sclerosis: a meta-analysis. J Public Health (Oxf), 2017; 39(2): 312-320.
[17]  Handel AE, Williamson AJ, Disanto G, Dobson R, Giovannoni G, Ramagopalan SV. Smoking and multiple sclerosis: an updated meta-analysis. PLoS One. 2011; 13(January): 6.
[18]  Brian C Healy 1, Eman N Ali, Charles R G Guttmann, Tanuja Chitnis, Bonnie I Glanz, Guy Buckle, et al. Arch Neurol. 2009; 66(7): 858-864.
[19]  Rosso M, Chitnis T. Association Between Cigarette Smoking and Multiple Sclerosis: A Review. JAMA Neurol. 2020; 77(2): 245-253.
[20]  Wingerchuk, D.M. Environmental factors in multiple sclerosis: Epstein-Barr virus, vitamin D, and cigarette smoking. Mt Sinai J Med. 2011:78: 221-230.
[21]  Roudbari SA, Ansar MM, Yousefzad A. Smoking as a risk factor for development of Secondary Progressive Multiple Sclerosis: A study in IRAN, Guilan. J Neurol Sci. 2013; 330(1-2): 52-55.
[22]  Dean M Wingerchuk. Smoking: effects on multiple sclerosis susceptibility and disease progression. Ther Adv Neurol Disord. 2012; 5(1): 13-22.
[23]  Kruja J, Beghi E, Zerbi D, et al. High prevalence of major neurological disorders in two Albanian communities: results of a door-to-door survey. Neuroepidemiology. 2012; 38(3): 138-147.
[24]  Cullen M O'Gorman, Simon A Broadley. Smoking increases the risk of progression in multiple sclerosis: A cohort study in Queensland, Australia. J Neurol Sci. 2016 Nov 15; 370: 219-223.
[25]  A K Hedström, T Olsson, L Alfredsson. Smoking Is a Major Preventable Risk Factor for Multiple Sclerosis. Mult Scler. 2016; 22(July); 8.
[26]  Ryan Ramanujam, Anna-Karin Hedström , Ali Manouchehrinia , Lars Alfredsson , Tomas Olsson , Matteo Bottai , et al. Effect of Smoking Cessation on Multiple Sclerosis Prognosis. JAMA Neurol. 2015; (October): 72.
[27]  Brian C. Healy, Eman Ali, Charles R.G. Guttmann, Tanuja Chitnis, Bonnie I. Glanz,, Guy Buckle, et. al Smoking and Disease Progression in Multiple Sclerosis. Arch Neurol. 2009; 66(7): 858-864.
[28]  R. Zivadinov, B. WeinstockGuttman, K. Hashmi, N. Abdelrahman, M. Stosic, M. Dwyer, et al. Smoking is associated with increased lesion volumes and brain atrophy in multiple sclerosis. Neurology. 2009; 73(7): 504-510.
[29]  Farren B. S. Briggs, Douglas D. Gunzler, Daniel Ontaneda and Ruth Ann Marrie. Smokers with MS have greater decrements in quality of life and disability than non-smokers. Mult Scler. 2017; 23(13): 1772-1781.