TY - JOUR
T1 - Effect modification of the association between total cigarette smoking and ALS risk by intensity, duration and time-since-quitting
T2 - Euro-MOTOR
AU - Peters, Susan
AU - Visser, Anne E.
AU - D'Ovidio, Fabrizio
AU - Vlaanderen, Jelle
AU - Portengen, L. tzen
AU - Beghi, Ettore
AU - Chio, Adriano
AU - Logroscino, Giancarlo
AU - Hardiman, Orla
AU - Pupillo, Elisabetta
AU - Veldink, Jan H.
AU - Vermeulen, Roel
AU - van den Berg, Leonard H.
AU - Euro-MOTOR consortium
AU - van der Kooi, Anneke J.
AU - Raaphorst, Joost
AU - Calvo, Andrea
AU - Moglia, Cristina
AU - Casale, Federico
AU - Fuda, Giuseppe
AU - Canosa, Antonio
AU - Manera, Umberto
AU - Bombaci, Alessandro
AU - Grassano, Maurizio
AU - Vasta, Rosario
AU - Salamone, Paolina
AU - Marrali, Giuseppe
AU - Iazzolino, Barbara
AU - Mazzini, Letizia
AU - Rooney, James
AU - Heverin, Mark
AU - Vajda, Alice
AU - Comi, Giancarlo
AU - Riva, Nilo
AU - Lunetta, Christian
AU - Gerardi, Francesca
AU - Filosto, Massimiliano
AU - Cotelli, Maria Sofia
AU - Rinaldi, Fabrizio
AU - Chiveri, Luca
AU - Guaita, Maria Cristina
AU - Perrone, Patrizia
AU - Mauro, Ceroni
AU - Diamanti, Luca
AU - Ferrarese, Carlo
AU - Tremolizzo, Lucio
AU - Delodovici, Maria Luisa
AU - Bono, Giorgio
AU - Tortelli, Rosanna
AU - Zecca, Chiara
PY - 2020/1/1
Y1 - 2020/1/1
N2 - Background We investigated the association between cigarette smoking and risk of amyotrophic lateral sclerosis (ALS) in a pooled analysis of population-based case-control studies and explored the independent effects of intensity, duration and time-since-quitting. Methods ALS cases and controls, matched by age, sex and region, were recruited in the Netherlands, Italy and Ireland (∗Euro-MOTOR project). Demographics and detailed lifetime smoking histories were collected through questionnaires. Effects of smoking status, intensity (cigarettes/day), duration (years), pack-years and time-since-quitting (years) on ALS risk were estimated using logistic regression models, adjusting for age, sex, alcohol, education and centre. We further investigated effect modification of the linear effects of pack-years by intensity, duration and time-since-quitting using excess OR (eOR) models. Results Analyses were performed on 1410 cases and 2616 controls. Pack-years were positively associated with ALS risk; OR=1.26 (95%CI: 1.03 to 1.54) for the highest quartile compared with never smokers. This association appeared to be predominantly driven by smoking duration (p trend=0.001) rather than intensity (p trend=0.86), although the trend for duration disappeared after adjustment for time-since-quitting. Time-since-quitting was inversely related to ALS (p trend <0.0001). The eOR decreased with time-since-quitting smoking, until about 10 years prior to disease onset. High intensity smoking with shorter duration appeared more deleterious than lower intensity for a longer duration. Conclusions Our findings provide further support for the association between smoking and ALS. Pack-years alone may be insufficient to capture effects of different smoking patterns. Time-since-quitting appeared to be an important factor, suggesting that smoking may be an early disease trigger.
AB - Background We investigated the association between cigarette smoking and risk of amyotrophic lateral sclerosis (ALS) in a pooled analysis of population-based case-control studies and explored the independent effects of intensity, duration and time-since-quitting. Methods ALS cases and controls, matched by age, sex and region, were recruited in the Netherlands, Italy and Ireland (∗Euro-MOTOR project). Demographics and detailed lifetime smoking histories were collected through questionnaires. Effects of smoking status, intensity (cigarettes/day), duration (years), pack-years and time-since-quitting (years) on ALS risk were estimated using logistic regression models, adjusting for age, sex, alcohol, education and centre. We further investigated effect modification of the linear effects of pack-years by intensity, duration and time-since-quitting using excess OR (eOR) models. Results Analyses were performed on 1410 cases and 2616 controls. Pack-years were positively associated with ALS risk; OR=1.26 (95%CI: 1.03 to 1.54) for the highest quartile compared with never smokers. This association appeared to be predominantly driven by smoking duration (p trend=0.001) rather than intensity (p trend=0.86), although the trend for duration disappeared after adjustment for time-since-quitting. Time-since-quitting was inversely related to ALS (p trend <0.0001). The eOR decreased with time-since-quitting smoking, until about 10 years prior to disease onset. High intensity smoking with shorter duration appeared more deleterious than lower intensity for a longer duration. Conclusions Our findings provide further support for the association between smoking and ALS. Pack-years alone may be insufficient to capture effects of different smoking patterns. Time-since-quitting appeared to be an important factor, suggesting that smoking may be an early disease trigger.
UR - https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85071113636&origin=inward
UR - https://www.ncbi.nlm.nih.gov/pubmed/31434759
U2 - https://doi.org/10.1136/jnnp-2019-320986
DO - https://doi.org/10.1136/jnnp-2019-320986
M3 - Article
C2 - 31434759
SN - 0022-3050
VL - 91
SP - 33
EP - 39
JO - Journal of Neurology, Neurosurgery and Psychiatry
JF - Journal of Neurology, Neurosurgery and Psychiatry
IS - 1
ER -