ArticleBrain : a journal of neurology2013
Tobacco smoking and disability progression in multiple sclerosis: United Kingdom cohort study.
Article in Brain : a journal of neurology, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 87 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
87 citing papers in PubMed, 2 syntheses or guidelines pooled it, 171 citations in OpenAlex.
- Smoking and disability outcomes in multiple sclerosis: a systematic review and meta-analysis.Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology · 2026Pooled it
- Risk factors associated with the onset of relapsing-remitting and primary progressive multiple sclerosis: a systematic review.BioMed research international · 2015Pooled it
- Vitamin D, smoking, EBV, and long-term cognitive performance in MS: 11-year follow-up of BENEFIT.Neurology · 2020Trial
- No association of multiple sclerosis activity and progression with EBV or tobacco use in BENEFIT.Neurology · 2015Trial
- Targeting progressive multiple sclerosis: Toward mechanism-informed precision medicine.Journal of internal medicine · 2026Review
- Interaction between smoking andMultiple sclerosis (Houndmills, Basingstoke, England) · 2026Article
- Tobacco smoking disrupts bile acid and tryptophan metabolism in multiple sclerosis.Multiple sclerosis (Houndmills, Basingstoke, England) · 2026Article
- IL-27-964 A/G polymorphism promoter polymorphism, serum IL-27, and vitamin D in multiple sclerosis: evidence from an egyptian case-control study.Molecular biology reports · 2026Article
- Dental-amalgam exposure and the risk and progression of multiple sclerosis.International journal of epidemiology · 2026Article
- Smoking accelerates immunosenescence in multiple sclerosis.Frontiers in immunology · 2026Review
- Comorbidity and modifiable risk factors in multiple sclerosis.Therapeutic advances in neurological disorders · 2026Review
- Investigating the treatment of vascular risk with simvastatin in secondary progressive multiple sclerosis: analysis from the MS-STAT2 randomized controlled trial.Brain communications · 2026Article
- Clusters of Comorbidities in Multiple Sclerosis and Their Influence on Healthcare Resource Usage.European journal of neurology · 2025Observational
- Sex-Related Differences in Lifestyle Factors Affecting Multiple Sclerosis Susceptibility and Disease Progression.Brain sciences · 2025Review
- Neuroprotective strategies in multiple sclerosis: a status update and emerging paradigms.Expert review of neurotherapeutics · 2025Review
- Advancements in multiple sclerosis.Internal medicine journal · 2025Review
- The Effect of Smoking and Passive Exposure on Multiple Sclerosis and Correlation with IL17 & IL23 Levels.Noro psikiyatri arsivi · 2025Article
- Relation Between Smoking and Disability Progression in Iranian Multiple Sclerosis Patients: A Case-Control Study.International journal of preventive medicine · 2025Article
- Motivators and barriers for smoking cessation in people with multiple sclerosis: a qualitative study to inform the design of a tailored intervention.BMC public health · 2024Article
- Obesity Control and Supplementary Nutraceuticals as Cofactors of Brain Plasticity in Multiple Sclerosis Populations.International journal of molecular sciences · 2024Review
27 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors at 2 institutions in 1 country.
Funding
Abstract
Tobacco smoking has been linked to an increased risk of multiple sclerosis. However, to date, results from the few studies on the impact of smoking on the progression of disability are conflicting. The aim of this study was to investigate the effects of smoking on disability progression and disease severity in a cohort of patients with clinically definite multiple sclerosis. We analysed data from 895 patients (270 male, 625 female), mean age 49 years with mean disease duration 17 years. Forty-nine per cent of the patients were regular smokers at the time of disease onset or at diagnosis (ever-smokers). Average disease severity as measured by multiple sclerosis severity score was greater in ever-smokers, by 0.68 (95% confidence interval: 0.36-1.01). The risk of reaching Expanded Disability Status Scale score milestones of 4 and 6 in ever-smokers compared to never-smokers was 1.34 (95% confidence interval: 1.12-1.60) and 1.25 (95% confidence interval: 1.02-1.51) respectively. Current smokers showed 1.64 (95% confidence interval: 1.33-2.02) and 1.49 (95% confidence interval: 1.18-1.86) times higher risk of reaching Expanded Disability Status Scale scores 4 and 6 compared with non-smokers. Ex-smokers who stopped smoking either before or after the onset of the disease had a significantly lower risk of reaching Expanded Disability Status Scale scores 4 (hazard ratio: 0.65, confidence interval: 0.50-0.83) and 6 (hazard ratio: 0.69, confidence interval: 0.53-0.90) than current smokers, and there was no significant difference between ex-smokers and non-smokers in terms of time to Expanded Disability Status Scale scores 4 or 6. Our data suggest that regular smoking is associated with more severe disease and faster disability progression. In addition, smoking cessation, whether before or after onset of the disease, is associated with a slower progression of disability.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.