Skip Page Header

Home > Effect modification of the association between total cigarette smoking and ALS risk by intensity, duration and time-since-quitting: Euro-MOTOR.

Peters, Susan and Visser, Anne E and D'Ovidio, Fabrizio and Vlaanderen, Jelle and Portengen, Lützen and Beghi, Ettore and Chio, Adriano and Logroscino, Giancarlo and Hardiman, Orla and Pupillo, Elisabetta and Veldink, Jan H and Vermeulen, Roel and van den Berg, Leonard H . (2020) Effect modification of the association between total cigarette smoking and ALS risk by intensity, duration and time-since-quitting: Euro-MOTOR. BMJ Publishing. Journal of Neurology, Neurosurgery, and Psychiatry, 91 (1)

URL: https://jnnp.bmj.com/content/early/2019/08/20/jnnp...

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=0.001) rather than intensity (p=0.86), although the trend for duration disappeared after adjustment for time-since-quitting. Time-since-quitting was inversely related to ALS (p<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.


Item Type
Evidence resource
Drug Type
Tobacco
Intervention Type
AOD prevention
Date
2020
Publisher
BMJ Publishing
Volume
91
Number
1
EndNote
Accession Number
HRB (Electronic Only)

Repository Staff Only: item control page