Investigating the Relationship Between Place of Residence and the Prevalence of Tobacco Smoking, Alcohol Consumption, and Drug Abuse in Iranian Multiple Sclerosis Patients

Multiple sclerosis (MS) is a chronic autoimmune and neurodegenerative disease that affects the central nervous system. Disparities in lifestyle, cultural aspects, and consequently, societal issues are apparent between individuals afflicted with multiple sclerosis (MS) residing in big cities versus those in small cities. In this cross-sectional study, the information of MS patients was collected through a researcher-made questionnaire in the format of Google form on social networks. In this questionnaire, patients were asked about the consumption of alcohol, cigarettes, drugs and water pipes. The place of residence of the patients was categorized into two groups of “big cities and small cities” or “Tehran (the capital city of Iran) and other cities”. The statistical analysis of this study was done through the Statistical Package for the Social Sciences (SPSS) software. A total of 427 MS patients participated in this study, of which 65.3% (n=279) were females. The average age of patients was 34.52 ± 7.15years. Among the patients, 75.9% (n=324) had relapsing-remitting MS (RRMS), 10.8% (n=46) had secondary progressive MS (SPMS), 8.9% (n=38) had primary progressive MS (PPMS), 3.3% (n=14) had clinically isolated syndrome (CIS), and 1.2% (n=5) had radiologically isolated syndrome (RIS). Among the participants 82.7% (n=353) lived in big cities, and 17.3% (n=74) lived in small cities, 60.2% (n=257) lived in Tehran, and 39.8% (n=170) lived in the other cities of Iran. The prevalence of water pipe consumption was significantly higher in the small cities, so that 31.2% (n=110) of patients living in the big cities and 43.2% (n=32) of patients living in the small cities reported water pipe use (p=0.04). In comparison between Tehran and other cities, the prevalence of alcohol consumption was significantly higher among patients residing in Tehran (n=136; 52.9%) as compared to those residing in other cities (n=67; 39.4%), p˂0.01. Considering the difference in culture and socio-economic status in different cities and regions, and the relationship between this differnece and alcohol and water pipe consumption, it is necessary to conduct more studies in this field. Considering that the consumption of alcohol and water pipe may have a negative effect on both the prevalence and severity of MS, it is necessary to consider the difference in their consumption rates among different cities in policymaking.