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Journal of Public Health

, Volume 25, Issue 5, pp 453–460 | Cite as

Tobacco smoking and multiple sclerosis: a systematic review of systematic and narrative reviews of observational studies

  • Insa Backhaus
  • Alice Mannocci
  • Giuseppe La Torre
Review Article

Abstract

Aim

The aim of this review was to systematically review systematic and narrative reviews of observational studies published on the relation between tobacco smoking and multiple sclerosis (MS).

Subjects and methods

A systematic search of the literature in PubMed and Scopus was conducted in June 2016. Two authors independently reviewed the search results and extracted key points. Review studies (i.e., review, systematic, narrative, or meta-analysis) that reported on smoking and MS were selected. The methodological quality of included systematic reviews and meta-analyses was assessed using the AMSTAR checklist. The methodological quality of narrative reviews was evaluated using a seven-item measure developed by the authors.

Results

Seventeen reviews met the inclusion criteria and were categorized as either systematic reviews or narrative reviews. Smoking was associated with increased risk of MS for ever- compared with never-smokers and current compared with non-smokers. The summary odds ratio of MS for ever-smokers versus never-smokers varied between 1.40 (95% CI: 1.29–1.52) and 1.46 (95% CI: 1.33–1.59).

Conclusion

This review of reviews identifies smoking as a risk factor for MS susceptibility. However, more research is needed to conclusively establish the mechanisms driving this association.

Keywords

Tobacco Smoking Multiple sclerosis Systematic review 

Notes

Acknowledgements

We thank Tyra Lagerberg for her thoughts and comments and for improving the use of English in the manuscript.

Compliance with ethical standards

Ethical standards

This article does not contain any patient data; thus, ethical approval was not required for this study.

Conflict of interest

The authors declare that they have no conflict of interest.

Funding

This study did not receive any funding.

Supplementary material

10389_2017_811_MOESM1_ESM.docx (16 kb)
ESM 1 (DOCX 16 kb)

References

  1. Ascherio A, Munger KL (2007) Environmental risk factors for multiple sclerosis. Part II: noninfectious factors. Ann Neurol 61:504–513. doi: 10.1002/ana.21141 CrossRefPubMedGoogle Scholar
  2. Ascherio A, Munger K (2008) Epidemiology of multiple sclerosis: from risk factors to prevention. Semin Neurol 28:17–28. doi: 10.1055/s-2007-1019126 CrossRefPubMedGoogle Scholar
  3. Backhaus I, Mannocci A, Lemmens PHHM, La Torre G (2016) Smoking as a risk factor for developing multiple sclerosis: a meta-analysis of observational studies. Clin Ter 167:82–92PubMedGoogle Scholar
  4. Evangelou N, Konz D, Esiri MM, Smith S, Palace J, Matthews PM (2000) Regional axonal loss in the corpus callosum correlates with cerebral white matter lesion volume and distribution in multiple sclerosis. Brain J Neurol 123(Pt 9):1845–1849CrossRefGoogle Scholar
  5. Fragoso YD (2014) Modifiable environmental factors in multiple sclerosis. Arq Neuropsiquiatr 72:889–894. doi: 10.1590/0004-282X20140159 CrossRefPubMedGoogle Scholar
  6. Giovannoni G, Ebers G (2007) Multiple sclerosis: the environment and causation. Curr Opin Neurol 20:261–268. doi: 10.1097/WCO.0b013e32815610c2 CrossRefPubMedGoogle Scholar
  7. Handel AE, Giovannoni G, Ebers GC, Ramagopalan SV (2010) Environmental factors and their timing in adult-onset multiple sclerosis. Nat Rev Neurol 6:156–166. doi: 10.1038/nrneurol.2010.1 CrossRefPubMedGoogle Scholar
  8. Handel AE, Williamson AJ, Disanto G, Dobson R, Giovannoni G, Ramagopalan SV (2011) Smoking and multiple sclerosis: an updated meta-analysis. PLoS One 6:e16149. doi: 10.1371/journal.pone.0016149 CrossRefPubMedPubMedCentralGoogle Scholar
  9. Hawkes CH (2007) Smoking is a risk factor for multiple sclerosis: a metanalysis. Mult Scler Houndmills Basingstoke Engl 13:610–615. doi: 10.1177/1352458506073501 CrossRefGoogle Scholar
  10. Hedström AK, Bäärnhielm M, Olsson T, Alfredsson L (2009) Tobacco smoking, but not Swedish snuff use, increases the risk of multiple sclerosis. Neurology 73:696–701. doi: 10.1212/WNL.0b013e3181b59c40 CrossRefPubMedGoogle Scholar
  11. Hedström AK, Sundqvist E, Bäärnhielm M, Nordin N, Hillert J, Kockum I, Olsson T, Alfredsson L (2011) Smoking and two human leukocyte antigen genes interact to increase the risk for multiple sclerosis. Brain J Neurol 134:653–664. doi: 10.1093/brain/awq371 CrossRefGoogle Scholar
  12. Hernán MA, Olek MJ, Ascherio A (2001) Cigarette smoking and incidence of multiple sclerosis. Am J Epidemiol 154:69–74. doi: 10.1093/aje/154.1.69 CrossRefPubMedGoogle Scholar
  13. Jafari N (2012) Risk factors in cause and course of multiple sclerosis. Naghmeh JafariGoogle Scholar
  14. Jafari N, Hintzen RQ (2011) The association between cigarette smoking and multiple sclerosis. J Neurol Sci 311:78–85CrossRefPubMedGoogle Scholar
  15. Kantarci O, Wingerchuk D (2006) Epidemiology and natural history of multiple sclerosis: new insights. Curr Opin Neurol 19:248–254. doi: 10.1097/01.wco.0000227033.47458.82 CrossRefPubMedGoogle Scholar
  16. La Torre G, Backhaus I, Mannocci A (2015) Rating for narrative reviews: concept and development of the International Narrative Systematic Assessment tool. https://www.researchgate.net/publication/280098483_Rating_for_narrative_reviews_concept_and_development_of_the_International_Narrative_Systematic_Assessment_tool. Accessed 18 Jan 2017
  17. Levine S (1967) Experimental cyanide encephalopathy: gradients of susceptibility in the corpus callosum. J Neuropathol Exp Neurol 26:214–222CrossRefPubMedGoogle Scholar
  18. McGowan J, Sampson M (2005) Systematic reviews need systematic searchers. J med Libr Assoc JMLA 93:74–80PubMedGoogle Scholar
  19. Munger KL, Ascherio A (2007) Risk factors in the development of multiple sclerosis. Expert rev Clin Immunol 3:739–748. doi: 10.1586/1744666X.3.5.739 CrossRefPubMedGoogle Scholar
  20. O’Gorman C, Broadley SA (2014) Smoking and multiple sclerosis: evidence for latitudinal and temporal variation. J Neurol 261:1677–1683. doi: 10.1007/s00415-014-7397-5 CrossRefPubMedGoogle Scholar
  21. O’Gorman C, Lucas R, Taylor B (2012) Environmental risk factors for multiple sclerosis: a review with a focus on molecular mechanisms. Int J Mol Sci 13:11718–11752. doi: 10.3390/ijms130911718 CrossRefPubMedPubMedCentralGoogle Scholar
  22. Oxman AD, Guyatt GH (1991) Validation of an index of the quality of review articles. J Clin Epidemiol 44:1271–1278. doi: 10.1016/0895-4356(91)90160-B CrossRefPubMedGoogle Scholar
  23. Pantazou V, Schluep M, Du Pasquier R (2015) Environmental factors in multiple sclerosis. Presse med 44:e113–e120. doi: 10.1016/j.lpm.2015.01.001 CrossRefPubMedGoogle Scholar
  24. Poorolajal J, Bahrami M, Karami M, Hooshmand E (2016) Effect of smoking on multiple sclerosis: a meta-analysis. J Public Health. doi: 10.1093/pubmed/fdw030
  25. Pugliatti M, Harbo HF, Holmøy T, Kampman MT, Myhr KM, Riise T, Wolfson C (2008) Environmental risk factors in multiple sclerosis. Acta Neurol Scand Suppl 188:34–40. doi: 10.1111/j.1600-0404.2008.01029.x CrossRefPubMedGoogle Scholar
  26. Shea BJ, Grimshaw JM, Wells GA, Boers M, Andersson N, Hamel C, Porter AC, Tugwell P, Moher D, Bouter LM (2007) Development of AMSTAR: a measurement tool to assess the methodological quality of systematic reviews. BMC med res Methodol 7:10. doi: 10.1186/1471-2288-7-10 CrossRefPubMedPubMedCentralGoogle Scholar
  27. Shirani A, Tremlett H (2010) The effect of smoking on the symptoms and progression of multiple sclerosis: a review. J Inflamm res 3:115–126. doi: 10.2147/JIR.S12059 CrossRefPubMedPubMedCentralGoogle Scholar
  28. Simon KC, Van der Mei IAF, Munger KL, Ponsonby A, Dickinson J, Dwyer T, Sundström P, Ascherio A (2010) Combined effects of smoking, anti-EBNA antibodies, and HLA-DRB1* 1501 on multiple sclerosis risk.Neurology 74(17):1365–1371. doi: 10.1212/WNL.0b013e3181dad57e
  29. Tullman MJ (2013) Overview of the epidemiology, diagnosis, and disease progression associated with multiple sclerosis. Am J Manag Care 19:S15–S20PubMedGoogle Scholar
  30. Wingerchuk DM (2011) Environmental factors in multiple sclerosis: Epstein-Barr virus, vitamin D, and cigarette smoking. Mt Sinai J med N Y 78:221–230. doi: 10.1002/msj.20240 CrossRefGoogle Scholar
  31. Wingerchuk DM (2012) Smoking: effects on multiple sclerosis susceptibility and disease progression. Ther Adv Neurol Disord 5:13–22. doi: 10.1177/1756285611425694 CrossRefPubMedPubMedCentralGoogle Scholar
  32. World Health Organization (2008) Atlas multiple sclerosis resources in the world 2008. Accessed 10 June 2016Google Scholar
  33. Young CA (2011) Factors predisposing to the development of multiple sclerosis. QJM Mon J Assoc Physicians 104:383–386. doi: 10.1093/qjmed/hcr012 CrossRefGoogle Scholar
  34. Zhang P, Wang R, Li Z, Wang Y, Gao C, Lv X, Song Y, Li B (2016) The risk of smoking on multiple sclerosis: a meta-analysis based on 20,626 cases from case-control and cohort studies. PeerJ 4:e1797. doi: 10.7717/peerj.1797 CrossRefPubMedPubMedCentralGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2017

Authors and Affiliations

  1. 1.Department of Public Health and Infectious DiseasesSapienza University of RomeRomeItaly

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