{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T14:26:54Z","timestamp":1787840814080,"version":"build-2784847793"},"reference-count":22,"publisher":"Ovid Technologies (Wolters Kluwer Health)","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"Abstract<\/jats:title>\n \n Background:<\/jats:title>\n To compare characteristics of patients with multiple sclerosis (MS) between cigarette smokers and non-smokers.<\/jats:p>\n <\/jats:sec>\n \n Methods:<\/jats:title>\n A case-control study was performed on patients registered in the Kashani MS center from April 2019 to April 2020 in Isfahan, Iran. In total, 136 smoker patients and 220 non-smokers participated in the study and completed the questionnaire.<\/jats:p>\n <\/jats:sec>\n \n Results:<\/jats:title>\n \n The frequency of male gender in the smoker group was significantly higher than in the non-smokers (64.7% vs. 15%,\n P<\/jats:italic>\n < 0.001). The mean age at MS onset was 31.5 \u00b1 9.60 years among cigarette smokers and 29.7 \u00b1 9.47 years among non-smokers (\n P<\/jats:italic>\n = 0.794). Furthermore, 80% of cigarette smokers and 64% of non-smokers had at least one relapse per year (ARR \u22651,\n P<\/jats:italic>\n < 0.001). The Expanded Disability Status Scale (EDSS) of more than 4.5 was significantly higher in smokers (26.5% vs. 18%,\n P<\/jats:italic>\n = 0.023). There was a relation between an EDSS of more than 4.5 and an interval between smoking initiation and disease onset (\n P<\/jats:italic>\n = 0.004). Long duration of smoking was associated with a higher disability scale (16.4 \u00b1 9.5 vs. 9.8 \u00b1 7.3,\n P<\/jats:italic>\n = 0.008). Men smoked for a longer period of time before developing MS than women (9.24 \u00b1 10.07 vs. 4.47 \u00b1 7.61,\n P<\/jats:italic>\n = 0.002). The average daily cigarette consumption was 7.74 \u00b1 6.65 in women and 10.84 \u00b1 9.44 in men (\n P<\/jats:italic>\n = 0.024). Duration of smoking before the onset of the disease was 4.47 \u00b1 7.61 years in women and 9.24 \u00b1 10.07 in men (\n P<\/jats:italic>\n = 0.002).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions:<\/jats:title>\n Our data suggest that there is a possible relationship between disability score and the duration of smoking before the onset of MS. It also revealed that the duration of smoking can affect the progression of the disease. Further studies are suggested to confirm these findings.<\/jats:p>\n <\/jats:sec>","DOI":"10.4103\/ijpvm.ijpvm_336_23","type":"journal-article","created":{"date-parts":[[2025,3,3]],"date-time":"2025-03-03T04:00:09Z","timestamp":1740974409000},"update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":1,"title":["Relation Between Smoking and Disability Progression in Iranian Multiple Sclerosis Patients: A Case-Control Study"],"prefix":"10.4103","volume":"16","author":[{"given":"Fereshteh","family":"Ashtari","sequence":"first","affiliation":[{"name":"Department of Neurology, School of Medicine, Isfahan University of Medical Sciences, Isfahan Neuroscience Research Center, Isfahan, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mahtab Sardashti","family":"Birjandi","sequence":"additional","affiliation":[{"name":"Department of Neurology, School of Medicine, Isfahan University of Medical Sciences, Isfahan Neuroscience Research Center, Isfahan, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Iman","family":"Adibi","sequence":"additional","affiliation":[{"name":"Department of Neurology, School of Medicine, Isfahan University of Medical Sciences, Isfahan Neuroscience Research Center, Isfahan, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Awat","family":"Feizi","sequence":"additional","affiliation":[{"name":"Department of Biostatistics and Epidemiology, Isfahan University of Medical Sciences, Isfahan, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arshia","family":"Ghalamkari","sequence":"additional","affiliation":[{"name":"Department of Neurology, School of Medicine, Isfahan University of Medical Sciences, Isfahan Neuroscience Research Center, Isfahan, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nafiseh","family":"Toghianifar","sequence":"additional","affiliation":[{"name":"Farabi Psychiatry and Ophthalmology Center, Isfahan University of Medical Sciences, Isfahan, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2025,2]]},"reference":[{"key":"R1-20250825","doi-asserted-by":"crossref","first-page":"27","DOI":"10.1111\/ene.13819","article-title":"Multiple sclerosis\u2013A review","volume":"26","author":"Dobson","year":"2019","journal-title":"Eur J Neurol"},{"key":"R2-20250825","first-page":"34","article-title":"Multiple sclerosis-A disease on a dramatically rising trend in Iran: Review of possible reasons","volume":"16","author":"Sahraian","year":"2017","journal-title":"Iran J Neurol"},{"key":"R3-20250825","doi-asserted-by":"crossref","first-page":"551","DOI":"10.5604\/01.3001.0010.3836","article-title":"Multiple sclerosis-etiology and diagnostic potential","volume":"71","author":"Kami\u0144ska","year":"2017","journal-title":"Postepy Hig Med Dosw (Online)"},{"key":"R4-20250825","doi-asserted-by":"crossref","first-page":"891","DOI":"10.1177\/1352458518823940","article-title":"The role of infections in multiple sclerosis","volume":"25","author":"Marrodan","year":"2019","journal-title":"Mult Scler"},{"key":"R5-20250825","doi-asserted-by":"crossref","first-page":"888","DOI":"10.1080\/01616412.2016.1227913","article-title":"High dose Vitamin D intake and quality of life in relapsing-remitting multiple sclerosis: A randomized, double-blind, placebo-controlled clinical trial","volume":"38","author":"Ashtari","year":"2016","journal-title":"Neurolog Res"},{"key":"R6-20250825","doi-asserted-by":"crossref","first-page":"243","DOI":"10.5603\/PJNNS.a2020.0032","article-title":"Smoking as a risk factor of onset and relapse of multiple sclerosis\u2014A review","volume":"54","author":"Jasielski","year":"2020","journal-title":"Neurol Neurochir Pol"},{"key":"R7-20250825","doi-asserted-by":"crossref","first-page":"840158","DOI":"10.3389\/fimmu.2022.840158","article-title":"Smoking attributable risk in multiple sclerosis","volume":"13","author":"Manouchehrinia","year":"2022","journal-title":"Front Immunol"},{"key":"R8-20250825","doi-asserted-by":"crossref","first-page":"e260","DOI":"10.1212\/NXI.0000000000000260","article-title":"No association between tobacco use and disease activity in multiple sclerosis","volume":"3","author":"Kvistad","year":"2016","journal-title":"Neurol Neuroimmunol Neuroinflammat"},{"key":"R9-20250825","doi-asserted-by":"crossref","first-page":"211","DOI":"10.1016\/j.jns.2013.10.046","article-title":"The association of alcohol consumption and smoking with quality of life, disability, and disease activity in an international sample of people with multiple sclerosis","volume":"336","author":"Weiland","year":"2014","journal-title":"J Neurol Sci"},{"key":"R10-20250825","doi-asserted-by":"crossref","first-page":"589","DOI":"10.1093\/ntr\/ntx084","article-title":"Smoking cessation and the reduction of disability progression in Multiple Sclerosis: A cohort study","volume":"20","author":"Tanasescu","year":"2018","journal-title":"Nicotine Tob Res"},{"key":"R11-20250825","doi-asserted-by":"crossref","first-page":"893","DOI":"10.12659\/MSM.912863","article-title":"Correlation between smoking and passive smoking with multiple sclerosis and the underlying molecular mechanisms","volume":"25","author":"Wang","year":"2019","journal-title":"Med Sci Monit"},{"key":"R12-20250825","first-page":"165","article-title":"Prevalence of cigarette smoking among college students in Iran: An updated systematic review and meta-analysis of observational studies","volume":"34","author":"Khodadost","year":"2020","journal-title":"Med J Islam Repub Iran"},{"key":"R13-20250825","doi-asserted-by":"crossref","first-page":"1328","DOI":"10.1177\/1352458516677867","article-title":"Waterpipe smoking associated with multiple sclerosis: A population-based incident case-control study","volume":"23","author":"Abdollahpour","year":"2017","journal-title":"Mult Scler"},{"key":"R14-20250825","doi-asserted-by":"crossref","first-page":"162","DOI":"10.1016\/S1474-4422(17)30470-2","article-title":"Diagnosis of multiple sclerosis: 2017 Revisions of the McDonald criteria","volume":"17","author":"Thompson","year":"2018","journal-title":"Lancet Neurol"},{"key":"R15-20250825","doi-asserted-by":"crossref","first-page":"2298","DOI":"10.1093\/brain\/awt139","article-title":"Tobacco smoking and disability progression in multiple sclerosis: United Kingdom cohort study","volume":"136","author":"Manouchehrinia","year":"2013","journal-title":"Brain"},{"key":"R16-20250825","doi-asserted-by":"crossref","first-page":"245","DOI":"10.1001\/jamaneurol.2019.4271","article-title":"Association between cigarette smoking and multiple sclerosis: A review","volume":"77","author":"Rosso","year":"2020","journal-title":"JAMA Neurol"},{"key":"R17-20250825","doi-asserted-by":"crossref","first-page":"1461","DOI":"10.1093\/brain\/awh471","article-title":"Cigarette smoking and the progression of multiple sclerosis","volume":"128","author":"Hern\u00e1n","year":"2005","journal-title":"Brain"},{"key":"R18-20250825","doi-asserted-by":"crossref","first-page":"866","DOI":"10.3389\/fneur.2019.00866","article-title":"The impact of lifetime alcohol and cigarette smoking loads on multiple sclerosis severity","volume":"10","author":"Ivashynka","year":"2019","journal-title":"Front Neurol"},{"key":"R19-20250825","doi-asserted-by":"crossref","first-page":"1515","DOI":"10.1212\/01.wnl.0000277658.78381.db","article-title":"Cigarette smoking and progression in multiple sclerosis","volume":"69","author":"Koch","year":"2007","journal-title":"Neurology"},{"key":"R20-20250825","doi-asserted-by":"crossref","first-page":"3083","DOI":"10.1007\/s00415-020-09980-4","article-title":"Smoking and multiple sclerosis risk: A Mendelian randomization study","volume":"267","author":"Vandebergh","year":"2020","journal-title":"J Neurol"},{"key":"R21-20250825","doi-asserted-by":"crossref","first-page":"1293","DOI":"10.1177\/1352458520968803","article-title":"Cotinine as a measure of smoking in observational studies of multiple sclerosis","volume":"27","author":"Hedstr\u00f6m","year":"2021","journal-title":"Mult Scler"},{"key":"R22-20250825","doi-asserted-by":"crossref","first-page":"858","DOI":"10.1001\/archneurol.2009.122","article-title":"Smoking and disease progression in multiple sclerosis","volume":"66","author":"Healy","year":"2009","journal-title":"Arch Neurol"}],"container-title":["International Journal of Preventive Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.4103\/ijpvm.ijpvm_336_23","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T13:29:28Z","timestamp":1787837368000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.4103\/ijpvm.ijpvm_336_23"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,2]]},"references-count":22,"URL":"https:\/\/doi.org\/10.4103\/ijpvm.ijpvm_336_23","relation":{},"ISSN":["2008-7802","2008-8213"],"issn-type":[{"value":"2008-7802","type":"print"},{"value":"2008-8213","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,2]]},"assertion":[{"value":"2023-12-10","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-05-16","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}