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Waterpipe smoking associated with multiple sclerosis: A population-based incident case-control study.

Ibrahim Abdollahpour1, Saharnaz Nedjat2, Mohammad Ali Sahraian3

  • 1Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran/School of Public Health, Arak University of Medical Sciences, Arak, Iran.

Multiple Sclerosis (Houndmills, Basingstoke, England)
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Summary

Waterpipe smoking is a newly identified risk factor for multiple sclerosis (MS). This study highlights the significant association between waterpipe, tobacco, and passive smoking and MS, emphasizing the need for public health interventions.

Keywords:
Multiple sclerosislogistic regressionpassive smokingpopulation-based incident case–controltobacco smokingwaterpipe smoking

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Area of Science:

  • Neurology
  • Epidemiology
  • Public Health

Background:

  • Multiple sclerosis (MS) is a chronic neurological disease with known links to cigarette and passive smoking.
  • The association between waterpipe smoking and MS has not been previously reported.

Purpose of the Study:

  • To investigate the association between waterpipe, tobacco, and passive smoking and the risk of developing multiple sclerosis.
  • To assess the combined effects and population attributable fractions of these smoking exposures on MS incidence.

Main Methods:

  • A population-based incident case-control study was conducted in Iran.
  • Data included 547 MS cases and 1057 controls, with logistic regression used for analysis.
  • Interactions and population attributable fractions (PAFs) were calculated to assess combined risks.

Main Results:

  • Waterpipe, tobacco, and passive smoking were all significantly associated with an increased risk of MS.
  • A clear dose-response relationship was observed for duration and amount of smoking for all three types.
  • Individuals exposed to all three types of smoking had a 4.1 times higher odds of MS; these exposures accounted for 30.9% of MS incidence.

Conclusions:

  • Waterpipe smoking is identified as a novel risk factor for multiple sclerosis.
  • The findings underscore the importance of public health initiatives to address the rising prevalence of waterpipe smoking, particularly among young adults.
  • Reducing exposure to all forms of smoking, including waterpipe, is crucial for MS prevention efforts.