Smoking cessation



Smoking has been associated with disease activity and overall prognosis for patients with MS [1]. According to a recent comprehensive literature review, smoking seems to affect patients with MS throughout the natural history of the disease, as well as possibly decreasing the efficacy of disease-modifying drugs [2]. Counseling is key in supporting patients before and during smoking cessation [2].


5A approach for smoking cessation [3]

  • Ask - Identify and document tobacco use status for every patient at every visit.
  • Advise - In a clear, strong, and personalized manner, urge every tobacco user to quit.
  • Assess - Is the tobacco user willing to make a quit attempt at this time?
  • Assist - For the patient willing to make a quit attempt, use counseling and pharmacotherapy to help him or her quit.
  • Arrange - Schedule follow-up contact, in person or by telephone, preferably within the first week after the quit date.



  • Jakimovski D et al. Neurodegener Dis Manag 2019; 9(3): 149-72. Return to content
  • Rosso M, Chitnis T. JAMA Neurol 2020; 77(2): 245-53. Return to content
  • Reference: Agency for Healthcare Research and Quality, Rockville, MD. (accessed August 18, 2021) Return to content
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