Pooled analysis of tobacco use and risk of Parkinson disease

Beate Ritz, Alberto Ascherio, Harvey Checkoway, Karen S. Marder, Lorene M. Nelson, Walter A Rocca, G. Webster Ross, Daniel Strickland, Stephen K. Van Den Eeden, Jay Gorell

Research output: Contribution to journalArticle

224 Citations (Scopus)

Abstract

Context: Epidemiologic studies have reported that cigarette smoking is inversely associated with Parkinson disease (PD). However, questions remain regarding the effect of age at smoking onset, time since quitting, and race/ethnicity that have not been addressed due to sample size constraints. This comprehensive assessment of the apparent reduced risk of PD associated with smoking may provide important leads for treatment and prevention. Objective: To determine whether race/ethnicity, sex, education, age at diagnosis, and type of tobacco modify the observed effects of smoking on PD. Design, Setting, and Participants: We conducted the first ever pooled analysis of PD combining individual-level data from 8 US case-control and 3 cohort studies (Nurses' Health Study, Health Professionals Follow-Up Study, and Honolulu-Asia Aging Study) conducted between 1960 and 2004. Case-control studies provided data for 2328 PD cases and 4113 controls matched by age, sex, and ethnicity; cohort studies contributed 488 cases and 4880 controls selected from age- and sex-matched risk sets. Main Outcome Measure: Incident PD. Results: We confirmed inverse associations between PD and smoking and found these to be generally stronger in current compared with former smokers; the associations were stronger in cohort than in case-control studies. We observed inverse trends with pack-years smoked at every age at onset except the very elderly (>75 years of age), and the reduction of risk lessened with years since quitting smoking. The risk reductions we observed for white and Asian patients were not seen in Hispanic and African American patients. We also found an inverse association both for smoking cigars and/or pipes and for chewing tobacco in male subjects. Conclusions: Our data support a dose-dependent reduction of PD risk associated with cigarette smoking and potentially with other types of tobacco use. Importantly, effects seemed not to be influenced by sex or education. Differences observed by race and age at diagnosis warrant further study.

Original languageEnglish (US)
Pages (from-to)990-997
Number of pages8
JournalArchives of Neurology
Volume64
Issue number7
DOIs
StatePublished - Jul 2007

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Tobacco Use
Parkinson Disease
Smoking
Sex Education
Risk Reduction Behavior
Age of Onset
Case-Control Studies
Cohort Studies
Smokeless Tobacco
Parkinson's Disease
Tobacco
Health
Hispanic Americans
African Americans
Sample Size
Epidemiologic Studies
Nurses
Outcome Assessment (Health Care)
Cohort
Ethnic Groups

ASJC Scopus subject areas

  • Neuroscience(all)

Cite this

Ritz, B., Ascherio, A., Checkoway, H., Marder, K. S., Nelson, L. M., Rocca, W. A., ... Gorell, J. (2007). Pooled analysis of tobacco use and risk of Parkinson disease. Archives of Neurology, 64(7), 990-997. https://doi.org/10.1001/archneur.64.7.990

Pooled analysis of tobacco use and risk of Parkinson disease. / Ritz, Beate; Ascherio, Alberto; Checkoway, Harvey; Marder, Karen S.; Nelson, Lorene M.; Rocca, Walter A; Ross, G. Webster; Strickland, Daniel; Van Den Eeden, Stephen K.; Gorell, Jay.

In: Archives of Neurology, Vol. 64, No. 7, 07.2007, p. 990-997.

Research output: Contribution to journalArticle

Ritz, B, Ascherio, A, Checkoway, H, Marder, KS, Nelson, LM, Rocca, WA, Ross, GW, Strickland, D, Van Den Eeden, SK & Gorell, J 2007, 'Pooled analysis of tobacco use and risk of Parkinson disease', Archives of Neurology, vol. 64, no. 7, pp. 990-997. https://doi.org/10.1001/archneur.64.7.990
Ritz B, Ascherio A, Checkoway H, Marder KS, Nelson LM, Rocca WA et al. Pooled analysis of tobacco use and risk of Parkinson disease. Archives of Neurology. 2007 Jul;64(7):990-997. https://doi.org/10.1001/archneur.64.7.990
Ritz, Beate ; Ascherio, Alberto ; Checkoway, Harvey ; Marder, Karen S. ; Nelson, Lorene M. ; Rocca, Walter A ; Ross, G. Webster ; Strickland, Daniel ; Van Den Eeden, Stephen K. ; Gorell, Jay. / Pooled analysis of tobacco use and risk of Parkinson disease. In: Archives of Neurology. 2007 ; Vol. 64, No. 7. pp. 990-997.
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abstract = "Context: Epidemiologic studies have reported that cigarette smoking is inversely associated with Parkinson disease (PD). However, questions remain regarding the effect of age at smoking onset, time since quitting, and race/ethnicity that have not been addressed due to sample size constraints. This comprehensive assessment of the apparent reduced risk of PD associated with smoking may provide important leads for treatment and prevention. Objective: To determine whether race/ethnicity, sex, education, age at diagnosis, and type of tobacco modify the observed effects of smoking on PD. Design, Setting, and Participants: We conducted the first ever pooled analysis of PD combining individual-level data from 8 US case-control and 3 cohort studies (Nurses' Health Study, Health Professionals Follow-Up Study, and Honolulu-Asia Aging Study) conducted between 1960 and 2004. Case-control studies provided data for 2328 PD cases and 4113 controls matched by age, sex, and ethnicity; cohort studies contributed 488 cases and 4880 controls selected from age- and sex-matched risk sets. Main Outcome Measure: Incident PD. Results: We confirmed inverse associations between PD and smoking and found these to be generally stronger in current compared with former smokers; the associations were stronger in cohort than in case-control studies. We observed inverse trends with pack-years smoked at every age at onset except the very elderly (>75 years of age), and the reduction of risk lessened with years since quitting smoking. The risk reductions we observed for white and Asian patients were not seen in Hispanic and African American patients. We also found an inverse association both for smoking cigars and/or pipes and for chewing tobacco in male subjects. Conclusions: Our data support a dose-dependent reduction of PD risk associated with cigarette smoking and potentially with other types of tobacco use. Importantly, effects seemed not to be influenced by sex or education. Differences observed by race and age at diagnosis warrant further study.",
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