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Cited by 19Amyotrophic Lateral Sclerosis ResearchSmoking Behavior and CessationParkinson's Disease Mechanisms and Treatments

UK case control study of smoking and risk of amyotrophic lateral sclerosis

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Opie-Martin, Sarah, Jones, Ashley, Iacoangeli, Alfredo, Al-Khleifat, Ahmad, Oumar, Mohamed, Shaw, Pamela J., Shaw, Chris E., Morrison, Karen E. +4 more·2020·Amyotrophic Lateral Sclerosis and Frontotemporal Degeneration
DOI 10.1080/21678421.2019.1706580PMC PMC7261396
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Abstract

Introduction: Susceptibility to amyotrophic lateral sclerosis (ALS) is associated with smoking in some studies, but it is not clear which aspect of smoking behavior is related. Using detailed records of lifetime smoking we investigated the relationship between smoking and ALS in a UK population. Methods: In this retrospective case-control study, smoking status was collected using environmental questionnaires from people diagnosed with ALS between 2008 and 2013 and from age, sex and geographically matched controls. Categorical measures of smoking behavior were: smoking at the time of survey and smoking initiation; continuous measures were intensity (cigarettes per day), duration (years from starting to stopping or time of survey), cigarette pack years, and comprehensive smoking index (CSI), a measure of lifetime smoking. We used logistic regression to assess the risk of ALS with different combinations of smoking variables adjusted for age at survey, gender, level of education, smoking status and alcohol initiation, selecting the best model using the Akaike Information Criterion. Results: There were 388 records with full smoking history. The best-fitting model used CSI and smoking status at the time of survey. We found a weak association between current smoking and risk of ALS, OR 3.63 (95% CI 1.02–13.9) p value 0.05. Increase in CSI score did not increase risk of ALS: OR 0.81 (95% CI 0.58–1.11) p value 0.2.Conclusion: There is weak evidence of a positive effect of current smoking on the risk of ALS which does not show dose-dependence with higher levels of lifetime smoking and maybe a false positive result.

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  • Some associations between environmental risk factors and ALS potentially vary by age, sex, and genetic factors.

    “with some of the associations potentially varying by age, sex, and genetic factors [11–15].”

    From Lifestyle and medical conditions in relation to ALS risk and progression—an introduction to the Swedish ALSrisc Study (2024) · cites this paper as [14]

    The Discussion reports that a meta-analysis found a higher smoking–ALS association in women, supporting possible variation by sex. The Introduction notes both genetic and environmental contributions to ALS, but does not say genetic factors modify environmental associations. The paper adjusts for age rather than reporting that the association varies by age; no page numbers are available in our copy. (LLM, conf=0.86)

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  • Some observational studies showed a positive association for current smoking but no association for former smoking with ALS risk.

    “Some observational studies showed a positive association for current smoking but no association for former smoking [7, 14, 15], while Mendelian Randomization studies have provided evidence for a causal link between smoking and risk for ALS [49].”

    From Lifestyle and medical conditions in relation to ALS risk and progression—an introduction to the Swedish ALSrisc Study (2024) · cites this paper as [14]

  • Exposure to oxidative stress and neurotoxic chemicals might provide a plausible biological explanation for the association between smoking and ALS.

    “The exposure to oxidative stress and neurotoxic chemicals might provide a plausible biological explanation for this association [14].”

    From Lifestyle and medical conditions in relation to ALS risk and progression—an introduction to the Swedish ALSrisc Study (2024) · cites this paper as [14]

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Research works printed but not linked: 23

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Authors
Opie-Martin, S., Jones, A., Iacoangeli, A., Al-Khleifat, A., Oumar, M., Shaw, P. J., Shaw, C. E., Morrison, K. E., Wootton, R. E., Davey-Smith, G., Pearce, N., & Al-Chalabi, A.
Affiliations
  • King's College London (GB)
  • Department of Basic and Clinical Neuroscience, Maurice Wohl Clinical Neuroscience Institute, King’s College London, London, United Kingdom,
  • University of Sheffield (GB)
  • University of Southampton (GB)
  • University Hospitals Bristol NHS Foundation Trust (GB)
  • MRC Integrative Epidemiology Unit at the University of Bristol, University of Bristol, Bristol, United Kingdom,
  • London School of Hygiene & Tropical Medicine (GB)
  • School of Psychological Science, University of Bristol, Bristol, United Kingdom,
Corresponding author
Opie-Martin, Sarah
ORCID
Venue
Amyotrophic Lateral Sclerosis and Frontotemporal Degeneration
Publisher
Informa UK Limited
Published
2020-04-02
Volume
21
Issue
3-4
Pages
222-227
ISSN
  • 2167-8421 (ISSN-L)
  • 2167-9223
DOI
10.1080/21678421.2019.1706580
PMC
PMC7261396
OpenAlex
W3010784988
Cited by
19
References
0
Citations by year
2025: 2 · 2024: 6 · 2023: 1 · 2022: 3 · 2021: 6 · 2020: 1
FWCI
1.19
Type
journal article
Language
en
Open access
Licence
Locations
  • Amyotrophic Lateral Sclerosis and Frontotemporal Degeneration (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • Bristol Research (University of Bristol) (publishedVersion, cc-by)
  • White Rose Research Online (University of Leeds, The University of Sheffield, University of York) (acceptedVersion)
  • ePrints Soton (University of Southampton) (acceptedVersion)
  • LSHTM Research Online (London School of Hygiene and Tropical Medicine) (acceptedVersion)
  • Explore Bristol Research (submittedVersion, cc-by)
  • Research Portal (Queen's University Belfast) (submittedVersion)
Funders
  • South London and Maudsley NHS Foundation Trust
  • Wellcome Trust (FP7/2007–2013)
  • EU Joint Programme – Neurodegenerative Disease Research (MR/L501529/1)
  • National Institute for Health and Care Research (ES/L008238/1, NF-SI-0617-10077, FP7/2007–2013, MR/L501529/1)
  • Motor Neurone Disease Association (ALCHALABI-TALBOT/APR14/926-794, 633413, 259867, ALCHALABI-DOBSON/APR14/829-791)
  • King's College London
  • Horizon 2020 Framework Programme (FP7/2007-2013, 633413, H2020-PHC-2014)
  • Medical Research Council (259867, ES/L008238/1, MR/R024804/1, MR/L501529/1, MC_UU_00011/1)
  • Economic and Social Research Council (ES/L008238/1, L008238, 633413, FP7/2007-2013)
Topics
  • Health Sciences › Medicine › Neurology › Amyotrophic Lateral Sclerosis Research
  • Health Sciences › Medicine › Physiology › Smoking Behavior and Cessation
  • Health Sciences › Medicine › Neurology › Parkinson's Disease Mechanisms and Treatments
Keywords
amyotrophic lateral sclerosis, smoking, lifetime smoking, smoking intensity, smoking duration, smoking initiation, current smoking, ALS risk factors, dose-response relationship
MeSH terms
Aged, Amyotrophic Lateral Sclerosis, Female, United Kingdom, Humans, Male, Middle Aged, Retrospective Studies, Risk Factors, Smoking, Case-Control Studies

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