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Turner AP, Hartoonian N, Maynard C, Leipertz SL, Haselkorn JK. Smoking and physical activity: examining health behaviors and 15-year mortality among individuals with multiple sclerosis. Archives of physical medicine and rehabilitation. 2015 Mar 1; 96(3):402-9.
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.