cigarette resting in an ashtray

4 Very Good Reasons to Quit Smoking When You Have MS

By Kerry Weiss
Reviewed by Dana Cooper, M.D.
May 15, 2023

When you’re living with multiple sclerosis (MS), making healthy lifestyle choices plays an important role in your overall disease management strategy. That includes things like eating a healthy diet, staying active, and quitting smoking.

According to the Cleveland Clinic, up to 52% of people living with MS have smoked at some point in their lives, and about 11% of people with MS are current smokers.

And although quitting is beneficial for pretty much anyone who smokes, it’s especially important for people with MS. “[Smoking] is just very pro-inflammatory—your immune system is living at a heightened state, because your immune system is what’s clearing out your lungs from all that gunk,” says James W. Stark, M.D., a neurologist at the International Multiple Sclerosis Management Practice, in New York City. “And in MS, we don't want our patients to be at a heightened immune state; we actually want them at a somewhat lower immune state.”

Here’s what to know about smoking with MS to help you get motivated to quit.

1. Smoking May Contribute to the Onset of MS

For those who are genetically susceptible to MS, smoking is a risk factor that is thought to play a role in the onset of the disease. According to the National Multiple Sclerosis Society (NMSS), smoking, as well as exposure to secondhand smoke, increases your risk of developing MS. A study published in 2012 suggests that the relative risk of developing MS is 1.5 times higher for smokers compared to nonsmokers.

2. Smoking Can Worsen MS

Smoking can continue to have an impact on the disease after you’ve been diagnosed, too. People who smoke tend to experience more disease activity (relapses and enhancing lesions on MRI), as well as accelerated brain volume loss, which may result in worse cognitive functioning and an overall higher level of disability, explains Julie Fiol, a registered nurse and associate vice president of healthcare access for the NMSS.

Smoking can also worsen pain related to MS. The habit can even increase your likelihood of progressing from relapsing-remitting MS to secondary progressive MS.

3. Smoking May Impair MS Treatment

“There is some evidence that cigarette smoking affects how well some disease-modifying therapies work, leading a smoker to derive less benefit than a nonsmoker,” Fiol says. This means that people who smoke may experience more relapses while taking disease-modifying therapy compared to those who don’t smoke. That’s because smoking is thought to affect the body’s ability to process these types of therapies.

4. Smoking Can Affect Other Areas of Your Health, Too

Smoking is associated with a variety of different negative health effects that can exacerbate MS. “Smoking contributes to the development of other health conditions, like cardiovascular disease, which are known to also worsen MS and lead to a shorter life span,” Fiol says. If you smoke, you’re also more likely to develop other autoimmune conditions or health issues, like diabetes or stroke, and it increases your risk of bone fractures

What’s more, in a given year, people who have MS and smoke are more than twice as likely to die as those living with MS who don’t smoke, according to researchers.

How to Kick the Habit

If you have MS, it’s not too late to quit smoking—and in fact, it can be highly beneficial. “The risks to disease progression can be minimized and potentially even reversed when someone with MS quits cigarette smoking,” Fiol says.

And what better time than now? “It never gets easier to quit smoking,” Stark says. “So however hard it is now, it will [likely] only be harder later in life.” The trick is making it stick.

6 Tips to Help You Quit Smoking

Stark shares this advice for people with MS who are ready to quit smoking:

1. Set a quit date—and stick with it.

2. As you approach the quit date, start limiting cigarettes.

3. Acknowledge your smoking triggers—what are the situations that make you want to light up?—and come up with a plan to address them.

4. Find activities that will distract you from smoking.

5. Ask for encouragement from friends and family.

6. Throw out any cigarettes you have.

Quit-Smoking Aids and Support

According to the American Cancer Society, only 4% to 7% of people are able to quit smoking on any given attempt without the assistance of smoking cessation aids or other help. So, be sure to ask your healthcare provider about stop-smoking aids that may be helpful for you, such as:

  • Nicotine replacement, like the patch, gum, or lozenge (such as Nicorette or NicoDerm)
  • Oral medication, like Chantix
  • Counseling
  • Support groups

While many people turn to vaping to help them quit smoking, you may want to steer clear of this when you have MS. “It's not even tobacco [that’s the problem]; it's the actual combustion of substances in your lungs,” Stark says. “So, we don't recommend vaping.”

“A comprehensive approach that involves medication and nonmedication therapies should be considered,” Fiol says. Also key? A positive attitude and perseverance.

It’s important to work with your healthcare team to determine the best smoking cessation plan for you. “A supportive network of family, friends, and healthcare providers is helpful during this process,” adds Fiol.

While you’re at it, be patient with yourself. Quitting is hard, and it can take time. Some sources estimate that it may take anywhere from eight to 14 attempts to quit for an extended period of time. The latest research suggests it may take 30 attempts or more to make it a full year without smoking.

But it’s truly worth the time and effort—for your health now and in the future.

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