Smoking and MS: Not a Good Match

Some interesting statistics about people with multiple sclerosis in the U.K. have been released by Public Health England. The numbers are intended to help health commissioners and providers assess “the needs of patients with MS and the provision of health and care services,” according to the government’s website.

Primary findings

• Nearly 106,000 people in England have MS. That’s 190 per 100,000 population, or almost two of every 1,000 people. About 5,000 new cases of MS are diagnosed each year in England. (A Multiple Sclerosis Society estimate covers England, Scotland, Wales, and Northern Ireland, and reports that about 130,000 people live with MS, with about 7,000 new cases diagnosed each year.)
• MS is more than twice as common in women as in men.
• Seventy-five percent of people with MS are 40 to 74 years old.
• Women 50 to 59 years old are three times more likely than men of that age to have MS.
• Smoking rates for men with MS are likely to be higher than the rate in the general population.
• Men and women with MS are more likely to be ex-smokers than the general population.

MS rates remain steady in England

Public Health England reports that the number of new MS cases diagnosed in England has held steady over nine fiscal years ending in 2017. “Each year there are on average 4,950 new case[s] diagnosed and recorded in primary care records.” That’s eight to 11 new cases per 100,000 population. The report calls that change “not statistically significant.” It’s encouraging that the number of cases doesn’t appear to be rising, but it’s discouraging that it’s not dropping.

Smoking and MS in the UK

A study recently published in JAMA Neurology reports that smoking may cause inflammation that increases the risk of MS, and that “patients with MS who smoke have higher rates of disease activity, faster rates of brain atrophy, and a greater disability burden.” The U.K.’s National Institute for Health and Care Excellence recommends that smokers with MS be advised to quit because smoking may increase their MS disability. The MS Society in the U.K. agrees with this advice.

It seems strange that with the knowledge available, Public Health England reports that 23 percent of men with MS and 15 percent of women with MS are smokers. Are healthcare professionals not relaying that important information about MS and smoking to their MS patients? The agency’s research suggests this may be the case. “[O]pportunities still exist to improve the public health messaging relating to smoking and the on-going management of MS,” the report notes. “This could include improvements in communication between specialist neurological staff who support people with MS and the providers of local smoking cessation services.”

That sounds like a good plan to me.

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