Smoking, Alcohol, and Multiple Sclerosis

Medically Reviewed by Carmelita Swiner, MD on March 02, 2023
3 min read

If you have multiple sclerosis (MS), you’re probably looking for changes you can make in your everyday life to feel better besides taking your medicine. At the top of the list should be quitting smoking. It does help with MS -- and with your health in general.

What about alcohol? Drinking in moderation is probably OK. But there are some things you should know.

People who smoke are more likely to get MS in the first place, compared to people who don’t. This might explain why so many people with MS are or used to be smokers. Even if you don’t smoke yourself, secondhand smoke from being around other people who do increases your risk for MS.

Smokers are about twice as likely to get MS as nonsmokers. They also more often get a progressive form of MS. It matters how much you smoke, too. Someone who smokes a pack a day is more likely to get MS than someone who used to smoke every once in a while in college.

If you smoke and you have MS, the disease is also more likely to get worse faster. Smokers tend to have more MS relapses than nonsmokers, too. Smokers might not get as much benefit from treatment as nonsmokers either.

All of this means you are at greater risk for disability if you smoke and have MS. For example, you might need a cane to get around sooner than you would if you didn’t smoke.

If you have MS or think you’re at risk for MS, now is the perfect time to stop.

Quitting can lower your risk for MS in the first place. If you have MS and quit smoking, it can help to slow down the disease. Your symptoms may not be as bad. You’ll be less likely to relapse as many times. If a doctor looked at your brain, they might see a difference.

So if you smoke and have MS, make a plan and find support to help you quit. Counseling can help you with this. Medications that help include:

If other people in your life smoke, you can encourage them to quit, too. Or at least ask them not to smoke around you. Secondhand smoke comes with risks for you just as smoking does.

Smoking with MS is clearly a no-no. But the research on alcohol is a bit less clear. Studies haven’t found a link between drinking a reasonable amount of alcohol and MS. There’s even some evidence that alcohol might limit the bad effects of smoking. The reasons for that aren’t clear, and more study is needed. It’s possible it has something to do with the way alcohol affects your immune system.

At least one study has shown that people who abuse alcohol are more likely to get MS. Abusing alcohol or drinking way too much has lots of health risks, whether you have MS or not. The research into MS and moderate drinking is lacking. 

Moderate drinking means no more than two drinks a day for men and one for women. A drink is 12 ounces of beer, 5 ounces of wine, or 1½ ounces (a “shot”) of 80-proof distilled spirits or liquor such as gin, rum, vodka, or whiskey.