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The association of alcohol consumption and smoking with quality of life, disability and disease activity in an international sample of people with multiple sclerosis

Published:December 02, 2013DOI:https://doi.org/10.1016/j.jns.2013.10.046

      Abstract

      Background

      Modifiable lifestyle factors represent important targets for preventive intervention in multiple sclerosis (MS). We aimed to explore the association of cigarette smoking and alcohol consumption with major MS morbidity outcomes.

      Methods

      We surveyed a large, international sample of people with MS recruited via Web 2.0 platforms about type of MS, relapse rates, disability, disease activity, health-related quality of life (HRQOL), alcohol use and smoking.

      Results

      Of 2469 respondents with confirmed MS, 11.7% were current and 40.3% former smokers. Most (61.5%) consumed less than 15 g alcohol weekly; few (0.8%) drank large amounts. Moderate alcohol consumption was associated with increased HRQOL; and after controlling for age and gender, was associated with lower odds of significant disability (41% decrease). After controlling for age, gender and alcohol use, smokers had an increased likelihood of major mobility requirements by 90% compared to never smokers. There was no association between alcohol or smoking and relapse rate or disease activity after controlling for age and gender, however among former smokers, a longer duration of smoking cessation was associated with reduced disease activity. Smokers had significantly lower HRQOL than never smokers and former smokers; heavier smoking was associated with greater decreases in HRQOL.

      Conclusion

      This cross-sectional study supports previous research showing a link between morbidity indicators in MS and alcohol use and smoking. While people with MS should be advised of the potential risks of smoking, any risks and benefits of alcohol consumption require validation using a prospective cohort of people with MS.

      Keywords

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      References

        • Alonso A.
        • Hernan M.A.
        Temporal trends in the incidence of multiple sclerosis: a systematic review.
        Neurology. Jul 8 2008; 71 ([Review]): 129-135
        • Ramagopalan S.V.
        • Dobson R.
        • Meier U.C.
        • Giovannoni G.
        Multiple sclerosis: risk factors, prodromes, and potential causal pathways.
        Lancet Neurol. Jul 2010; 9: 727-739https://doi.org/10.1016/S1474-4422(10)70094-6
        • Marrie R.
        • Horwitz R.
        • Cutter G.
        • Tyry T.
        • Campagnolo D.
        • Vollmer T.
        High frequency of adverse health behaviors in multiple sclerosis.
        Mult Scler. Jan 2009; 15 ([Research Support, N.I.H., Extramural]): 105-113
        • Bricker J.B.
        • Schiff L.
        • Comstock B.A.
        Does avoidant coping influence young adults' smoking?: a ten-year longitudinal study.
        Nicotine Tob Res. Oct 2011; 13 ([Research Support, N.I.H., Extramural]): 998-1002
        • Cooper M.L.
        • Russell M.
        • Skinner J.B.
        • Frone M.R.
        • Mudar P.
        Stress and alcohol use: moderating effects of gender, coping, and alcohol expectancies.
        J Abnorm Psychol. Feb 1992; 101 ([Research Support, U.S. Gov't, P.H.S.]): 139-152
        • Folkman S.
        • Moskowitz J.T.
        Coping: pitfalls and promise.
        Annu Rev Psychol. 2004; 55 ([Review]): 745-774
        • Brown R.F.
        • Valpiani E.M.
        • Tennant C.C.
        • Dunn S.M.
        • Sharrock M.
        • Hodgkinson S.
        • et al.
        Longitudinal assessment of anxiety, depression, and fatigue in people with multiple sclerosis.
        Psychol Psychother. Mar 2009; 82 ([Research Support, Non-U.S. Gov't]): 41-56
        • Riise T.
        • Nortvedt M.W.
        • Ascherio A.
        Smoking is a risk factor for multiple sclerosis.
        Neurology. Oct 28 2003; 61: 1122-1124
        • Hernan M.A.
        • Olek M.J.
        • Ascherio A.
        Cigarette smoking and incidence of multiple sclerosis.
        Am J Epidemiol. Jul 1 2001; 154 ([Research Support, U.S. Gov't, P.H.S.]): 69-74
        • Hawkes C.H.
        Smoking is a risk factor for multiple sclerosis: a meta-analysis.
        Mult Scler. Jun 2007; 13 ([Meta-Analysis]): 610-615
        • Healy B.C.
        • Ali E.N.
        • Guttmann C.R.
        • Chitnis T.
        • Glanz B.I.
        • Buckle G.
        • et al.
        Smoking and disease progression in multiple sclerosis.
        Arch Neurol. Jul 2009; 66 ([Research Support, N.I.H., Extramural Research Support, Non-U.S. Gov't]): 858-864
        • Pittas F.
        • Ponsonby A.L.
        • van der Mei I.A.
        • Taylor B.V.
        • Blizzard L.
        • Groom P.
        • et al.
        Smoking is associated with progressive disease course and increased progression in clinical disability in a prospective cohort of people with multiple sclerosis.
        J Neurol. Apr 2009; 256 ([Research Support, Non-U.S. Gov't]): 577-585
        • Sundstrom P.
        • Nystrom L.
        Smoking worsens the prognosis in multiple sclerosis.
        Mult Scler. Sep 2008; 14 ([Research Support, Non-U.S. Gov't]): 1031-1035
        • Nortvedt M.W.
        • Riise T.
        • Maeland J.G.
        Multiple sclerosis and lifestyle factors: the Hordaland Health Study.
        Neurol Sci. Dec 2005; 26 ([Comparative Study]): 334-339
        • Ghadirian P.
        • Jain M.
        • Ducic S.
        • Shatenstein B.
        • Morisset R.
        Nutritional factors in the aetiology of multiple sclerosis: a case–control study in Montreal, Canada.
        Int J Epidemiol. Oct 1998; 27 ([Research Support, Non-U.S. Gov't]): 845-852
        • Hawkes C.H.
        Are multiple sclerosis patients risk-takers?.
        QJM. Dec 2005; 98 ([Review]): 895-911
        • Goodin D.S.
        Survey of multiple sclerosis in northern California. Northern California MS Study Group.
        Mult Scler. Apr 1999; 5: 78-88
        • D'Hooghe M.B.
        • Haentjens P.
        • Nagels G.
        • De Keyser J.
        Alcohol, coffee, fish, smoking and disease progression in multiple sclerosis.
        Eur J Neurol. Apr 2012; 19: 616-624
        • Foster M.
        • Zivadinov R.
        • Weinstock-Guttman B.
        • Tamano-Blanco M.
        • Badgett D.
        • Carl E.
        • et al.
        Associations of moderate alcohol consumption with clinical and MRI measures in multiple sclerosis.
        J Neuroimmunol. Feb 29 2012; 243 ([Research Support, N.I.H., Extramural Research Support, U.S. Gov't, Non-P.H.S.]): 61-68
        • Scott I.C.
        • Tan R.
        • Stahl D.
        • Steer S.
        • Lewis C.M.
        • Cope A.P.
        The protective effect of alcohol on developing rheumatoid arthritis: a systematic review and meta-analysis.
        Rheumatology (Oxford). May 2013; 52: 856-867
        • Hadgkiss E.J.
        • Jelinek G.A.
        • Weiland T.J.
        • Rumbold G.
        • Mackinlay C.A.
        • Gutbrod S.
        • et al.
        Health-related quality of life outcomes at 1 and 5 years after a residential retreat promoting lifestyle modification for people with multiple sclerosis.
        Neurol Sci. Feb 2013; 34 ([Research Support, Non-U.S. Gov't]): 187-195
        • Li M.P.
        • Jelinek G.A.
        • Weiland T.J.
        • Mackinlay C.A.
        • Dye S.
        • Gawler I.
        Effect of a residential retreat promoting lifestyle modifications on health-related quality of life in people with multiple sclerosis.
        Qual Prim Care. 2010; 18 ([Clinical Trial]): 379-389
        • Olascoaga J.
        Quality of life and multiple sclerosis.
        Rev Neurol. Sep 1 2010; 51 ([Review]): 279-288
        • Schipper S.
        • Wiesmeth S.
        • Wirtz M.
        • Twork S.
        • Kugler J.
        Coping strategies and health-related quality of life in multiple sclerosis patients.
        Psychother Psychosom Med Psychol. Aug 2011; 61: 347-355
        • Tadic D.
        • Dajic V.
        Quality of life in patients with multiple sclerosis in Republic of Srpska.
        Med Glas Ljek komore Zenicko-doboj kantona. Feb 2013; 10: 113-119
        • Hadgkiss E.J.
        • Jelinek G.A.
        • Weiland T.J.
        • Pereira N.G.
        • Marck C.H.
        • van der Meer D.M.
        Methodology of an international study of people with multiple sclerosis recruited through Web 2.0 platforms: demographics, lifestyle, and disease characteristics.
        Neurol Res Int. 2013; 2013: 12
        • Liang Y.
        • Mente A.
        • Yusuf S.
        • Gao P.
        • Sleight P.
        • Zhu J.
        • et al.
        Alcohol consumption and the risk of incident atrial fibrillation among people with cardiovascular disease.
        CMAJ. Nov 6 2012; 184 ([Comparative Study Research Support, Non-U.S. Gov't]): E857-E866
        • Acquadro C.
        • Lafortune L.
        • Mear I.
        Quality of life in multiple sclerosis: translation in French Canadian of the MSQoL-54.
        Health Qual Life Outcomes. 2003; 1 ([Research Support, Non-U.S. Gov't Validation Studies]): 70
        • Solari A.
        • Filippini G.
        • Mendozzi L.
        • Ghezzi A.
        • Cifani S.
        • Barbieri E.
        • et al.
        Validation of Italian multiple sclerosis quality of life 54 questionnaire.
        J Neurol Neurosurg Psychiatry. Aug 1999; 67 ([Comparative Study Research Support, Non-U.S. Gov't]): 158-162
        • Yamamoto T.
        • Ogata K.
        • Katagishi M.
        • Shimizu H.
        • Ogawa M.
        • Yamamura T.
        • et al.
        Validation of the Japanese-translated version Multiple Sclerosis Quality of Life-54 instrument.
        Rinsho Shinkeigaku. Jul 2004; 44 ([Research Support, Non-U.S. Gov't Validation Studies]): 417-421
        • Hohol M.J.
        • Orav E.J.
        • Weiner H.L.
        Disease steps in multiple sclerosis: a simple approach to evaluate disease progression.
        Neurology. Feb 1995; 45: 251-255
        • Marrie R.A.
        • Cutter G.
        • Tyry T.
        • Hadjimichael O.
        • Campagnolo D.
        • Vollmer T.
        Changes in the ascertainment of multiple sclerosis.
        Neurology. Oct 11 2005; 65 ([Research Support, Non-U.S. Gov't]): 1066-1070
        • Marrie R.A.
        • Cutter G.
        • Tyry T.
        • Vollmer T.
        • Campagnolo D.
        Does multiple sclerosis-associated disability differ between races?.
        Neurology. Apr 25 2006; 66 ([Comparative Study Research Support, N.I.H., Extramural Research Support, Non-U.S. Gov't]): 1235-1240
        • Hadjimichael O.
        • Vollmer T.
        • Oleen-Burkey M.
        Fatigue characteristics in multiple sclerosis: the North American Research Committee on Multiple Sclerosis (NARCOMS) survey.
        Health Qual Life Outcomes. 2008; 6 ([Research Support, Non-U.S. Gov't]): 100
        • Arriola L.
        • Martinez-Camblor P.
        • Larranaga N.
        • Basterretxea M.
        • Amiano P.
        • Moreno-Iribas C.
        • et al.
        Alcohol intake and the risk of coronary heart disease in the Spanish EPIC cohort study.
        Heart. Jan 2010; 96 ([Multicenter Study Research Support, Non-U.S. Gov't]): 124-130
        • Emberson J.R.
        • Bennett D.A.
        Effect of alcohol on risk of coronary heart disease and stroke: causality, bias, or a bit of both?.
        Vasc Health Risk Manag. 2006; 2 ([Review]): 239-249
        • Vliegenthart R.
        • Oei H.H.
        • van den Elzen A.P.
        • van Rooij F.J.
        • Hofman A.
        • Oudkerk M.
        • et al.
        Alcohol consumption and coronary calcification in a general population.
        Arch Intern Med. Nov 22 2004; 164 ([Research Support, Non-U.S. Gov't]): 2355-2360
        • Bombardier C.H.
        • Blake K.D.
        • Ehde D.M.
        • Gibbons L.E.
        • Moore D.
        • Kraft G.H.
        Alcohol and drug abuse among persons with multiple sclerosis.
        Mult Scler. Feb 2004; 10 ([Research Support, U.S. Gov't, Non-P.H.S.]): 35-40
        • D'Hooghe M.B.
        • Nagels G.
        • Bissay V.
        • De Keyser J.
        Modifiable factors influencing relapses and disability in multiple sclerosis.
        Mult Scler. Jul 2010; 16 ([Research Support, Non-U.S. Gov't Review]): 773-785
        • Wen X.J.
        • Kanny D.
        • Thompson W.W.
        • Okoro C.A.
        • Town M.
        • Balluz L.S.
        Binge drinking intensity and health-related quality of life among US adult binge drinkers.
        Prev Chronic Dis. 2012; 9: E86
        • D'Hooghe M.B.
        • De Keyser J.
        Associations of alcohol consumption with clinical and MRI measures in multiple sclerosis.
        Expert Rev Neurother. Jun 2012; 12 ([Comment]): 657-660
        • Sillanaukee P.
        • Massot N.
        • Jousilahti P.
        • Vartiainen E.
        • Sundvall J.
        • Olsson U.
        • et al.
        Dose response of laboratory markers to alcohol consumption in a general population.
        Am J Epidemiol. Oct 15 2000; 152: 747-751
        • Imhof A.
        • Woodward M.
        • Doering A.
        • Helbecque N.
        • Loewel H.
        • Amouyel P.
        • et al.
        Overall alcohol intake, beer, wine, and systemic markers of inflammation in western Europe: results from three MONICA samples (Augsburg, Glasgow, Lille).
        Eur Heart J. Dec 2004; 25 ([Multicenter Study]): 2092-2100
        • Heikkinen H.
        • Jallinoja P.
        • Saarni S.I.
        • Patja K.
        The impact of smoking on health-related and overall quality of life: a general population survey in Finland.
        Nicotine Tob Res. Jul 2008; 10 ([Research Support, Non-U.S. Gov't]): 1199-1207
        • Hays J.T.
        • Croghan I.T.
        • Baker C.L.
        • Cappelleri J.C.
        • Bushmakin A.G.
        Changes in health-related quality of life with smoking cessation treatment.
        Eur J Public Health. Apr 2012; 22 ([Randomized Controlled Trial Research Support, Non-U.S. Gov't]): 224-229
        • Kalra R.
        • Singh S.P.
        • Savage S.M.
        • Finch G.L.
        • Sopori M.L.
        Effects of cigarette smoke on immune response: chronic exposure to cigarette smoke impairs antigen-mediated signaling in T cells and depletes IP3-sensitive Ca2+ stores.
        J Pharmacol Exp Ther. Apr 2000; 293 ([Research Support, U.S. Gov't, Non-P.H.S. Research Support, U.S. Gov't, P.H.S.]): 166-171
        • Freeman A.G.
        Optic neuropathy and chronic cyanide intoxication: a review.
        J R Soc Med. Feb 1988; 81 ([Review]): 103-106