Smoking can worsen multiple sclerosis (MS) symptoms, increase brain atrophy, and cause earlier death. Stopping smoking may improve symptoms such as weakness and spasticity.

MS is a neurodegenerative condition that can cause significant impairment. Some studies suggest that around 1 in 4 people with MS smoke tobacco. However, there is evidence that smoking can worsen this condition.

This article looks at the effects of smoking on people with MS. It also discusses whether quitting smoking could help improve symptoms.

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MS is an autoimmune, neurodegenerative disease. Individuals develop MS when their immune system starts attacking the myelin sheath surrounding their neurons. The myelin sheath protects neurons and improves their transfer of electrical signals.

According to a 2022 paper, tobacco smoking is a risk factor for more serious forms of MS. Although scientists are unsure why this is, they have documented the following effects of smoking on people with MS:

Motor symptoms

People who smoke have a greater risk of experiencing more significant MS motor symptoms.

When the myelin sheath breaks down, signals cannot pass easily from neuron to neuron. This means that people with MS can experience motor symptoms that vary in severity. They include:

Read about MS and spasticity.

Brain atrophy

As the myelin sheath protects neurons from damage, people with MS are more prone to neuronal degeneration. This can cause brain atrophy, which is more significant in smokers.

Cognitive and psychological problems

As a neurological condition, MS can lead to cognitive and psychological issues, including:

  • memory problems
  • executive dysfunction, including difficulty managing thoughts, feelings, and actions
  • problems with concentration
  • depression
  • anxiety

Smoking with MS correlates with increased cognitive and psychological impairment.


MS is degenerative, meaning it worsens over time. As the disease progresses, people can experience issues with breathing and eating. They can also experience brain damage. All these complications can lead to an earlier death compared with people without the condition.

There are many types of MS, including relapsing MS, which involves periods where the disease suddenly worsens. Research suggests that people with relapsing MS who smoke are more likely to die earlier.

Secondary progressive MS

Smokers with relapsing MS tend to develop secondary progressive MS more quickly.

Secondary progressive MS is a form of progressive MS. In progressive MS, the disease gradually worsens over time rather than suddenly worsening during certain periods. It is “secondary” as it follows relapsing MS.

Learn more about MS.

There is evidence that quitting smoking can help people manage MS. In particular, quitting smoking slows the rate at which MS motor symptoms worsen.

Scientists do not know whether other MS symptoms might improve after quitting smoking.

Nicotine is highly addictive, which makes quitting smoking difficult. According to a 2023 review, the following interventions can improve a person’s chances of quitting successfully:

Although electronic cigarettes can help with smoking cessation, scientists do not yet understand their long-term health effects. It is also unclear how using them may affect MS.

Find 11 tips for giving up smoking.

The following are common questions about MS and smoking.

Is smoking cannabis to relieve MS symptoms OK?

Although some evidence suggests that oral cannabis products or cannabis sprays can relieve certain MS symptoms, scientists have not looked at how smoking cannabis smoking might affect MS disease progression.

Learn more about cannabis and MS.

Is smoking good for relieving stress in people with MS?

No scientific evidence suggests that smoking is good for stress management in people with MS.

Smoking can have a negative effect on MS. As well as correlating with worse motor and psychological issues, smoking also worsens brain atrophy. Smoking can lead to earlier secondary progressive MS and earlier death.

There is evidence that quitting smoking can benefit people with MS. In particular, it can lower the rate at which motor symptoms develop.