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January 01, 1999; 52 (1) Articles

Smoking and Parkinson’s disease

A dose–response relationship

Jay M. Gorell, Benjamin A. Rybicki, Christine Cole Johnson, Edward L. Peterson
First published January 1, 1999, DOI: https://doi.org/10.1212/WNL.52.1.115
Jay M. Gorell
MD
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Benjamin A. Rybicki
PhD
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Christine Cole Johnson
PhD
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Edward L. Peterson
PhD
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Citation
Smoking and Parkinson’s disease
A dose–response relationship
Jay M. Gorell, Benjamin A. Rybicki, Christine Cole Johnson, Edward L. Peterson
Neurology Jan 1999, 52 (1) 115; DOI: 10.1212/WNL.52.1.115

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Abstract

Objective: To determine whether an inverse dose–response relationship exists between cigarette smoking and PD among ever-smokers and ex-smokers.

Methods: Smoking and alcohol consumption were analyzed in 144 PD patients and 464 control subjects, who were frequency matched for sex, race, and age (±5 years), in a population-based case-control study of men and women ≥50 years old in the Henry Ford Health System.

Results: With never-smokers as the reference category, there was an inverse association between current light smokers (>0 to 30 pack-years) and PD patients (odds ratio [OR], 0.59; 95% CI, 0.23 to 1.53), and a stronger inverse association of PD with current heavy smokers (>30 pack-years; OR, 0.08; 95% CI, 0.01 to 0.62). When former >30–pack-year smokers were stratified by the interval since quitting, there was an inverse association between those who stopped >20 years ago and PD (OR, 0.86; 95% CI, 0.42 to 1.75), and a greater inverse relationship with those who stopped 1 to 20 years ago (OR, 0.37; 95% CI, 0.19 to 0.72). Alcohol consumption had no independent, significant association with PD, but heavy drinking (>10 drink-years) had a greater effect than light–moderate drinking in reducing but not eliminating the inverse association between smoking and PD.

Conclusions: The inverse dose–response relationship between PD and smoking and its cessation is unlikely to be due to bias or confounding, as discussed, providing indirect evidence that smoking is biologically protective.

  • Received June 8, 1998.
  • Accepted September 5, 1998.
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