Smoking and physical activity: examining health behaviors and 15-year mortality among individuals with multiple sclerosis

Abstract

Objectives: To examine 2 modifiable health behaviors-smoking and physical activity-and their relationship to mortality among individuals with multiple sclerosis (MS).

Design: Secondary analysis of Large Health Survey.

Setting: Data were obtained from a linkage of the Veterans Affairs (VA) MS National Data Repository, containing information on service provision to all individuals with MS receiving health services within the U.S. Department of Veterans Affairs; the VA 1999 Large Health Survey, containing information on smoking and physical activity; and the VA Vital Status File. All-cause mortality was examined for the 15-year period from 1999 through 2013.

Participants: Participants (N=2994) with MS who completed the Large Health Survey containing information on smoking and physical activity.

Interventions: Not applicable.

Main outcome measure: Survival.

Results: There were 1500 deaths (50.1%) during the study period. Cox proportional hazard analyses were conducted to examine the association between smoking and physical activity and 15-year mortality. After adjusting for demographic factors, physical functioning, mental health, and comorbid medical conditions, baseline smoking was associated with greater mortality (hazard ratio [HR]=1.38; 95% confidence interval [CI], 1.184-1.60). Higher levels of baseline physical activity were associated with lower mortality (activity 1-2 times/wk: HR=.64; 95% CI, .518-.798; activity ≥3 times/wk: HR=.53; 95% CI, .388-.715).

Conclusions: Results suggest that modifiable health behaviors represent a promising opportunity for intervention to improve the lives of individuals with MS.

Keywords: Exercise; Mortality; Multiple sclerosis; Physical activity; Rehabilitation; Smoking.