title: Association between Smoking and Health Outcomes in Postmenopausal Women Living with Multiple Sclerosis.
abstract: Background. In multiple sclerosis (MS), symptom management and improved health-related quality of life (HrQOL) may be modified by smoking. Objective. To evaluate the extent to which smoking is associated with worsened health outcomes and HrQOL for postmenopausal women with MS. Methods. We identified 251 Women's Health Initiative Observational Study participants with a self-reported MS diagnosis. Using a linear model, we estimated changes from baseline to 3 years for activities of daily living, total metabolic equivalent tasks (MET) hours per week, mental and physical component scales (MCS, PCS) of the SF-36, and menopausal symptoms adjusting for years since menopause and other confounders. Results. Nine percent were current and 50% past smokers. Age at smoking initiation was associated with significant changes in MCS during menopause. PCS scores were unchanged. While women who had ever smoked experienced an increase in physical activity during menopause, the physical activity levels of women who never smoked declined. Residual confounding may explain this finding. Smoking was not associated with change in menopausal symptoms during the 3-year follow-up. Conclusion. Smoking was not associated with health outcomes among post-menopausal women with MS.
authors.affiliation: Department of Epidemiology and Community Health, Virginia Commonwealth University School, Richmond, VA 23284, USA.
authors.forename: Rachel
authors.identifier: 0000-0002-8178-9351
authors.initials: R
authors.lastname: Jawahar
authors.affiliation: Department of Neurology, Virginia Commonwealth University School, Richmond, VA 23284, USA.
authors.forename: Unsong
authors.identifier: 0000-0002-1762-5299
authors.initials: U
authors.lastname: Oh
authors.affiliation: Center for Primary Care and Prevention, Memorial Hospital of Rhode Island, Pawtucket, RI 02861, USA.
authors.forename: Charles
authors.initials: C
authors.lastname: Eaton
authors.affiliation: Department of Epidemiology, University of Alabama Birmingham, Birmingham, AL 35294, USA.
authors.forename: Nicole
authors.identifier: 0000-0001-8414-4842
authors.initials: N
authors.lastname: Wright
authors.affiliation: Department of Medicine, University of Pittsburgh, Pittsburgh, PA 15260, USA.
authors.forename: Hilary
authors.initials: H
authors.lastname: Tindle
authors.affiliation: Department of Quantitative Health Sciences, University of Massachusetts Medical School, 55 Lake Avenue North, Worcester, MA 01655, USA.
authors.forename: Kate L
authors.initials: KL
authors.lastname: Lapane