Association between smoking, waterpipe, drug and alcohol abuse with Multiple Sclerosis (PP-34)

Multiple sclerosis is a chronic disease of the central nervous system, which, like any other autoimmune disease, has unknown environmental risk factors that can be triggered by smoking, drugs, and alcohol. This population-based case-control study was conducted in Tabriz, Iran. MS cases were confirmed by neurologists based on McDonald's criteria, and standard random dialing (RDD) was used to select healthy control group participants from the patients' residence, with gender matching. 141 MS cases and 564 control group people were included in the study. The mean age (SD) for cases and controls was (9.4%) 47.0 and (6.1%) 37.7 (P=0.001). Smoking and history of exposure to cigarette smoke were considered as risk factors associated with MS (OR = 2.48; 95%CI = 1.44-4.27 and OR = 2.20; 95%CI = 1.34-3.62, respectively). However, hookah smoking history was not significantly related to MS (OR = 1.19; 95%CI = 0.62-2.26). Those who used all three methods of tobacco consumption (cigarettes, passive smoking, and hookah) were 2.76 times more likely to develop MS than those who had no contact with tobacco. There is no significant relationship between different types of drugs and alcohol and MS (opioids: OR = 0.90; 95%CI = 2.29-0.35, cannabis: OR = 1.58; 95%CI = 0.47-5.24, stimulants: OR = 0.14-4.87, consumption of beer: OR = 0.29-1.26, consumption of whiskey/vodka: OR = 0.34-1.49, wine consumption: OR = 0.73; 95%CI = 0.35-1.53). The results show that smoking and exposure to secondhand smoke are important risk factors for the occurrence of MS and those who use all three methods have a higher chance of getting MS than people who have not had any contact with tobacco use. These findings emphasize the intervention program for the prevention of cigarette and hookah consumption.