Smoking and MS

There's a range of things you can do to manage your MS. And if you currently smoke, making a plan to give up is one of them.

There’s increasing evidence suggesting smoking is a factor in MS getting worse. That’s why official guidelines from NICE (National Institute for Health and Care Excellence) recommend that people with MS don’t smoke.

What’s the evidence?

Studies have pointed towards a link between smoking and MS for decades. In general, studies find the more cigarettes you smoke, and the longer you’re a smoker, the bigger the chance you’ll either get MS or your MS will get worse.

Recently a major review of 56 studies found strong evidence of a significant link between smoking and getting MS. This risk is 50% higher than for non-smokers.

There’s a lot of evidence showing smoking makes relapsing MS worse.

There’s also some evidence that smokers with relapsing MS go on to get secondary progressive MS faster.

Most of the studies looking at the effects of smoking on MS have focused on relapsing MS, so there's less evidence related to primary progressive and secondary progressive MS. It’s also not yet clear if passive smoking poses a risk. More research looking at the effects of smoking on MS is needed.

Quitting makes sense

Stopping smoking has real benefits.

Quitting could mean fewer relapses, less disability and fewer lesions (areas of damage in the brain or spinal cord). One study showed people who quit after a diagnosis of relapsing MS took eight years longer to reach progressive MS compared those who carried on smoking.

Studies have also shown quitting could help with memory, thinking and muscle strength.

And then there’s the money. On average, most people who quit save about £250 a month. That's nearly £3,000 a year.

Your GP can help you to stop smoking. Find out how much you’d save and get ideas and support, from nicotine gum and patches to e-cigarettes and vaping at

Why smoking is a risk

Nicotine doesn’t seem to be the problem. It’s the poisonous chemicals in tobacco smoke that we think affect your immune system.

Several things could explain how smoking affects MS:

  • smoking causes inflammation in your body
  • lowers your vitamin D levels
  • affects your hormones
  • means blood circulates around your body and into your brain less easily.

Smokers are more likely to get infections too, and these are known to trigger relapses.

More generally, smokers are at risk of heart disease, cancers, strokes and lung conditions that cause serious breathing problems.

Smoking and DMTs

Some studies have shown that, when smokers are taking some disease modifying therapies (DMTs), these treatments work less well. This is because the immune system is more likely to make ‘neutralising antibodies’ to the drug. So far this has been noticed in people on natalizumab (Tysabri) and the beta interferons.