Interaction of alcohol consumption and smoking on Multiple Sclerosis severity course: a cross-sectional study (P1.139)

Objective: This study aimed to evaluate the effect of smoking and alcohol and their possible interaction on the clinical course of Multiple Sclerosis (MS). Background: Alcohol and tobacco are the most widely used legal drugs in the world. To date, it’s unclear their influence on the course of MS and consequently whether it is necessary to recommend stopping or decrease smoking and drinking of alcoholic beverages to patients with MS. Design/Methods: MS patients were recruited in the Novara Hospital (Italy) in 2009–2012. Smoking and alcohol history were evaluated with the European Prospective Investigation into Cancer and Nutrition lifestyle questionnaire. Severity of MS was assessed through the Multiple Sclerosis Severity Score (MSSS). Age- and gender-adjusted logistic regression models were estimated comparing the MSSS upper versus lower tertiles. Results: MS patient group included 351 patients, 190 ever-smokers and 283 ever-drinkers. Sex ratio (M/F) was 0.49 and relapsing-remitting form accounted for 76%. Ever-smokers were almost two times more likely to fall in the upper tertile compared with never-smokers (p=0.024). When analyzing smoke-alcohol interaction, the subgroup of ever-smoker/never-drinker patients was six times more likely to fall in the upper MSSS tertile compared with the subgroup of never-smoker/never-drinker patients (p=0.013) MSSS was the lowest in patients who never drunk and never smoked (MSSS median – 1.0), the highest severity in patients who smoked but never drunk (MSSS median – 6.3), and intermediate in patients who only drunk (MSSS median – 1.6), or both drunk and smoked (MSSS median – 2.4; p for trend Conclusions: Our study revealed that cigarette smoking only is associated with more severe disease course, but in combination with alcohol consumption tends to less pronounced increasing MSSS level. Disclosure: Dr. Ivashynka has nothing to disclose. Dr. Arcuti has nothing to disclose. Dr. Vecchio has nothing to disclose. Dr. Naldi has nothing to disclose. Dr. D9Alfonso has nothing to disclose. Dr. Copetti has nothing to disclose. Dr. Leone has nothing to disclose.