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Wednesday, January 6, 2016

Symptom Co-occurrences Associated with Smoking Among Individuals with Relapsing-Remitting Multiple Sclerosis

Pamela NewlandRN, PhD, CMSRNLouise FlickDrPH, MSN, MPEHong XianPhD;Florian P. ThomasMD, MA, PhD
From the Goldfarb School of Nursing at Barnes Jewish College, St Louis, MO, USA (PN); College for Public Health and Social Justice (LF, HX) and Department of Neurology (FPT), Saint Louis University, St. Louis, MO, USA; and VISN 15 Regional MS Center of Excellence, St. Louis VA Medical Center, St. Louis, MO, USA (FPT).
Correspondence: Pamela Newland, RN, PhD, CMSRN, Goldfarb School of Nursing at Barnes Jewish College, 4483 Duncan Ave., St Louis, MO 63110; e-mail: .
Background: The impact of tobacco on multiple sclerosis (MS) disease process and symptoms is complex and not clearly understood. Tobacco may be used to self-treat symptoms but also appears to intensify others. Studies to date have not characterized co-occurring symptoms (symptom patterns) and their association with tobacco use.
Methods: This study describes tobacco use among patients with relapsing-remitting MS (RRMS) and associated symptoms and symptom co-occurrences. In this cross-sectional study, 101 participants with an average age of 43 years completed a survey adapted from the Behavioral Risk Factor Surveillance System and the revised MS Related Symptom Scale (R-MS-RS). Data reduction was performed using factor analysis on the 43 items of the R-MS-RS, and linear regression was used to detect association between symptom clusters (factors) and smoking.
Results: Using the factor analysis result, the linear regression analysis found that tobacco use is positively associated with co-occurring symptoms and symptoms of Factor 1: Mental/Emotional (anxiety, loneliness, depression, and difficulty sleeping) and Factor 4: Neuro/Autonomic (urinary).
Conclusions: Smoking is associated with patterns of symptoms. Study of MS and tobacco use over time will allow determination of the temporal pattern of tobacco use and MS symptoms.
Published Online: 2015-12-23

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