Smoking and Multiple Sclerosis

• A/Prof Claudia Marck

  claudia.marck@unimelb.edu.au
  

Project Details

Smoking is a key determinant of multiple sclerosis (MS) onset and is related to faster disease and disability progression, lower quality of life, increased depression, anxiety and higher premature mortality. Persistent smokers reached the progressive stage of MS eight years earlier compared with those who quit after diagnosis. Smoking cessation reduces the risk of disability progression significantly, and the earlier people with MS quit the stronger this effect. Between 2020 and 2026 A/Prof Claudia Marck led several projects to better understand barriers and motivators to smoking cessation among people with MS (e.g. stress management, MS-specific challenges), and what their needs for smoking cessation programs are. Parallel work with clinicians revealed gaps in current cessation support practices and limited MS-specific guidance. She led the chapter on smoking cessation in the MS Australia commissioned Modifiable Lifestyle guides in 2020 and 2025 (https://www.msaustralia.org.au/lifestyle/). Between 2023-2026 she co-supervised a PhD project completed by Dr Max Keller, who replicated some of this work and developed a tailored smoking cessation intervention for people with MS in Germany, where smoking rates are more than double compared to Australia. Feasibility studies in Germany tested the intervention's acceptability, delivery and preliminary outcomes, with results now in press. As part of this PhD project they also completed an umbrella review to synthesise evidence on the effects of smoking and vaping on MS onset and disease progression, strengthening the rationale for cessation efforts.

Publications:

1. Marck CH, das Nair R, Grech LB, Borland R, Constantinescu CS (2020) Modifiable risk factors for poor health outcomes in multiple sclerosis: The urgent need for research to maximise smoking cessation success. Mult Scler 26:266-271
2. Hunter A, Grech LB, Borland R, das Nair R, White SL, Marck CH (2021) Barriers and motivators for tobacco smoking cessation in people with multiple sclerosis. Mult Scler Relat Disord 54:103085
3. Grech LB, Hunter A, das Nair R, Borland R, Marck CH (2021) Improving smoking cessation support for people with multiple sclerosis: A qualitative analysis of clinicians' views and current practice. Mult Scler Relat Disord 56:103289
4. Weld-Blundell I, Grech L, Borland R, White SL, das Nair R, Marck CH (2022) Smoking habits, awareness and support needs for cessation among people with multiple sclerosis in Australia: findings from an online survey. BMJ Open 12:e059637
5. Keller AM, von Glasenapp B, Kotz D, Marck CH, Heesen C, Riemann-Lorenz K (2024) Motivators and barriers for smoking cessation in people with multiple sclerosis: a qualitative study to inform the design of a tailored intervention. BMC Public Health 24:3402
6. Keller AM, Marck CH, Kotz D, von Glasenapp B, Heesen C, Riemann-Lorenz K (2025) Smoking cessation in people with multiple sclerosis: qualitative study on the current practices and barriers for delivering assistance from the perspective of healthcare professionals in Germany. BMJ Open 15:e091950
7. Keller AM, Kotz D, Marck CH, Wöhler A, Heesen C, Riemann-Lorenz K. (2025) Smoking and multiple sclerosis: Development and feasibility study of a MS-specific smoking cessation intervention. Therapeutic Advances in Neurological Disorders 18, 17562864251391057
8. Keller AM, Kotz D, Marck CH, Friemel CM, Heesen C, Riemann-Lorenz K. A tailored Smoking Cessation Intervention for People with Multiple Sclerosis: Results of a Feasibility Study. Sage Open Chronic Disease (accepted 2026).
9. The effects of smoking and vaping on multiple sclerosis onset and disease progression: an umbrella review (under review)

Links:

1. Podcast: Smoking and MS. 2023. German MS society. https://ms-perspektive.de/193-stop-smoking
2. Blog: Understanding smoking behaviour and providing smoking cessation support. 2021. Multiple Sclerosis Australia website, newsletter. https://www.msaustralia.org.au/project/understanding-smoking-behaviour/
3. Blog: Is there enough support for people with MS to stop smoking? 2021. Multiple Sclerosis Australia website and newsletter. https://www.msaustralia.org.au/news/is-there-enough-support-for-people-with-ms-to-stop-smoking/
4. Webinar: Smoking and multiple sclerosis. (>1300 views) MSPlus. 2021. https://www.msplus.org.au/resources/smoking-and-multiple-sclerosis
5. Podcast: Smoking and MS. MSPlus. 2020. https://www.msplus.org.au/resources/smoking-and-ms
6. Video blog: MS Mythbusters: Myth – Nicotine is harmful for people with MS (534 views). 2020. Multiple Sclerosis Australia website and socials. https://www.msaustralia.org.au/news/ms-mythbusters-smoking/
7. Video blog: Modifiable Lifestyle Factors: Smoking (600 views). 2020. Multiple Sclerosis Australia website and socials.  https://www.msaustralia.org.au/news/modifiable-lifestyle-factors-smoking/
8. Interview: Smoking Cessation Success in Multiple Sclerosis Should Be a Priority. 2019. NeurologyLive. https://www.neurologylive.com/view/smoking-cessation-success-multiple-sclerosis-should-be-priority

Researchers

A/Prof Claudia Marck, University of Melbourne
Dr Lisa Grech, Swinburne University
Professor Ron Borland, University of Melbourne and Cancer Council
Professor  Roshan das Nair, University of Nottingham
Professor Cris Constantinescu, University of Nottingham

Collaborators

Quit Victoria and Cancer Council

Funding

National Health and Medical Research Council Early Career Fellowship