International Journal of Epidemiology, Vol 26, 328-339, Copyright © 1997 by International Epidemiological Association
W Hellenbrand, A Seidler, BP Robra, P Vieregge, WH Oertel, J Joerg, P Nischan, E Schneider and G Ulm
BACKGROUND: In a hospital based case-control study, we investigated the
role of environmental factors in the aetiology of Parkinson's disease. This
paper describes our results on smoking habits. METHODS: The smoking
histories of 380 Parkinson's disease (PD) patients recruited from nine
German clinics were compared to those of age- and sex-matched control
subjects (379 neighbourhood controls and 376 controls from the same
region). Detailed information on smoking behaviour was collected in
structured personal interviews in order to calculate the number of
pack-years smoked up to the time of diagnosis. Conditional logistic
regression was used to calculate odds ratios (OR) and control for potential
confounders. RESULTS: Among PD patients, 44% had ever smoked, as compared
to 59% in both control groups. Among ever-smoking patients, 74% quit prior
to the date of diagnosis, as compared to roughly 45% of the ever-smoking
control subjects. The OR for ever having smoked was 0.5 (95% confidence
interval [CI]: 0.3-0.7), P trend < 0.00005). CONCLUSIONS: The results
are considered in terms of criteria for causality. Plausible explanations
for the observed inverse association between smoking and PD include: 1. A
genetic predisposition that increases the risk for PD (such as defective
detoxification enzymes) simultaneously decreases the likelihood of smoking.
2. Inherently lower dopamine levels in predestined PD patients cause them
to be less prone to addiction. 3. Smoking is neuroprotective.
ARTICLES
Smoking and Parkinson's disease: a case-control study in Germany
Institute of Social Medicine, Faculty of Medicine, Otto-von-Guericke University, Magdeburg, Germany.
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