Cut out the Ciggies


Many years ago people used to collect cards from cigarette packets….Now I wonder if people collect Cigarette Packets to get the set of health-related gruesome pictures.

Cigarettes for Manchester City fans

Likewise I wonder if arms manufacturers shouldl adopt this policy when they sell their guns in the US, as I suspect they could be more dangerous than smoking..

Anyway, if you have not been living under a rock for the past few decades, I am sure you will be aware of the issues around smoking and health. You all know what the paper below says and that is….if you smoke, it may be detrimental to your health.

Yes I know there is overlap and some never-smokers do worse than smokers, meaning some smokers do OK.

The study below says that on the whole you lose more brain if you smoke when you have MS and this subtle difference may have some clinical consequences. Smoking is something in your control and you chose whether to smoke or not. So maybe you could consider stopping if you smoke and the best way to deal with it, is to never start in the first place.

As an Ex-addict, I know it is hard and that being told what to do is one of the best ways to ensure that people don’t do it, if you are of that mind set. Likewise, you are not daft and you are aware of risk, but you don’t bin you car because you may have a fatal car crash sometime in the future and you certainly don’t bin it because of brain damage due to poluted air from car exhausts. Are the risks of smoking worse than car driving:-)

You have to want to do it for it to be successful and for me I planned to stop. I gradually went from the “cowboy ciggie” to the “puffing on air” ciggie such that there was more nicotine a patch than the “cancer stick”, when I decide to quit. I found another vice to distract myself….Not telling you what they were:-)

No it wasn’t the pies but Size Lard came

The UK government has demonised smoking, but there are aids to help you quit. However, they are certainly taxing it out of existence…however, making you go on holiday to buy cheap ciggies abroad was a pleasure and not a disincentive. A cost of a flight could be less than a pack…..If only I could have persuaded ProfG to get me “duty-free” from the airport every time he went to a meeting I could have had hundreds of ciggies a week:-). I wouldn’t have had to go on Squeezy jet weekend holidays so much:-).

Now we seem to be in a time when smokers are a dying breed and we are in the process of de-alcoholling oursleves…..whilst we are being turned into a nation of online gamblers (Yep madness)……yep we dont have to go to the reservation of Altantic City, it’s on the tele and our phones and online. Papers of alcohol consumption and MS have surfaced

You know anything to excess can be bad for your and other people health and don’t get me started on religion, but that wouldn’t be P.C. would it.

I wonder if the Scandies will search their registries to determine whether religions influence your MS?

Is the Chruch of Scotland associated with the higher frequency of MS than the Church of England? :}

Maybe this would be more interesting that targeting smoking. If your risk of death from smoking doubles should you worry is the risk of dying went from 1 in 20,000,000 to 2 in 20,000,000. What about ice cream consumption? Is it worse than smoking? We don’t do these comparisons but maybe we should as it may be easier to stop eating ice cream

I suspect that if you have read this far… You don’t need the message “Just Quit”….it’s the people who only read the title and say I’m not interested…..The problem is it’s in our nature to ignore risk.

We are now all out and about and don’t seem to give a flying fig about COVID-19, which is on the rise, but yesterday according to Doctor Goolge there were 117 COVID-related deaths in the UK, which is nearly 6 times more than this time last year when we were lock-up at home.

Lie IA, Wesnes K, Kvistad SS, Brouwer I, Wergeland S, Holmøy T, Midgard R, Bru A, Edland A, Eikeland R, Gosal S, Harbo HF, Kleveland G, Sørenes YS, Øksendal N, Barkhof F, Vrenken H, Myhr KM, Bø L, Torkildsen Ø. The Effect of Smoking on Long-term Gray Matter Atrophy and Clinical Disability in Patients with Relapsing-Remitting Multiple Sclerosis. Neurol Neuroimmunol Neuroinflamm. 2022 Jun 23;9(5):e200008.

Background and objectives: The relationship between smoking, long-term brain atrophy, and clinical disability in patients with multiple sclerosis (MS) is unclear. Here, we assessed long-term effects of smoking by evaluating MRI and clinical outcome measures after 10 years in smoking and nonsmoking patients with relapsing-remitting MS (RRMS).

Methods: We included 85 treatment-naive patients with RRMS with recent inflammatory disease activity who participated in a 10-year follow-up visit after a multicenter clinical trial of 24 months. Smoking status was decided for each patient by 2 separate definitions: by serum cotinine levels measured regularly for the first 2 years of the follow-up (during the clinical trial) and by retrospective patient self-reporting. At the 10-year follow-up visit, clinical tests were repeated, and brain atrophy measures were obtained from MRI using FreeSurfer. Differences in clinical and MRI measurements at the 10-year follow-up between smokers and nonsmokers were investigated by 2-sample t tests or Mann-Whitney tests and linear mixed-effect regression models. All analyses were conducted separately for each definition of smoking status.

Results: After 10 years, smoking (defined by serum cotinine levels) was associated with lower total white matter volume (p = 0.039) and higher logT2 lesion volume (p = 0.011). When defining smoking status by patient self-reporting, the repeated analyses found an additional association with lower deep gray matter volume (p = 0.049), and smoking was also associated with a higher score (higher walking impairment) on the log timed 25-foot walk test (p = 0.039) after 10 years and a larger decrease in paced auditory serial addition test (attention) scores (β = 0.029).

Discussion: Smoking was associated with brain atrophy and disability progression 10 years later in patients with RRMS. The findings imply that patients should be advised and offered aid in smoking cessation shortly after diagnosis, to prevent long-term disability progression.

COI Ex-smoker

Dislcaimer: My mad ideas are my own and noone else

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  • I can recommend Allen Carr’s “Easy Way” method – I wasn’t even intending to give up when I gave up.
    I have to say it was the best thing I ever did – took a couple of months to feel the benefits but boy – it made such a difference.

    I know people who can’t quit – many of whom now vape instead, they don’t smoke, only vaping. Honestly the difference it’s made to their health stopping smoking (even with the vaping). It would be interesting to see if the benefits of giving up tobacco extend to vapers for pwMS. Not everybody CAN quit – but if vaping were to be of almost equal benefit it would be a reasonable compromise. (I don’t vape either, I have no skin in this game, just don’t like seeing people suffer unnecessarily.)

  • I remember being in a group of pwMS once and a guy said he had quit smoking after being diagnosed because his doctor told him to. I know he is in the minority but I have a feeling if I was a smoker I would do the same – the authority of the white coat is quite powerful. I’ve just spent two months off running because my GP told me no running or cycling pending the outcome of a 24-hour Holter monitor (I passed out at home one night). It was HELL but I got through it. And my heart is fine (mostly – some extra beats apparently). Thank goodness I am allowed to cycle again now that case numbers are rising. I can avoid taking public transport now. My office is still fairly empty – many staff have even moved out of London. And we have no outbreaks associated with the office. So I feel safe there and will return now that I can get there safely (I’ll probably get hit by a truck now).

    You mention alcohol consumption – I understood moderate alcohol consumption is good in MS but has there been more research? I hit my head quite hard when I went down so had to lay off alcohol until I recovered and kind of kept that going… I have started drinking again this past weekend but I am still limiting my consumption and choosing low/no alcohol alternatives.

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