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Prospective Study of Cigarette Smoking and Amyotrophic Lateral Sclerosis
Abstract
Cigarette smoking has been proposed as a risk factor for amyotrophic lateral sclerosis (ALS), but because of the low incidence of ALS this association has been examined only with case-control methods. The authors prospectively assessed the relation between cigarette smoking and ALS mortality among participants in the Cancer Prevention Study II cohort of the American Cancer Society, a cohort of over 1 million people enrolled in 1982 who completed a lifestyle questionnaire including a detailed smoking history at baseline. Causes of deaths were ascertained through death certificates; ALS was not identified separately until 1989. From January 1, 1989, through 1998, 291 women and 330 men died from ALS. The relative risk of ALS among current smokers compared with never smokers was 1.67 (95% confidence interval: 1.24, 2.24; p = 0.002) in women and 0.69 (95% confidence interval: 0.49, 0.99; p = 0.04) in men. The difference in the relative risk estimates between the sexes was statistically significant (p < 0.0003). This large prospective study provides limited evidence that current cigarette smoking may be associated with increased death rates from ALS in women but not in men.
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Cigarette smoking has previously been associated with ALS risk.
“Environmental factors that have previously been associated with ALS risk include cigarette smoking (3–5)”
From Association of ALS with head injury, cigarette smoking and APOE genotypes (2010) · cites this paper as [5]
A prospective study based on ALS mortality data found that an association with cigarette smoking was restricted to women.
“A prospective study based on ALS mortality data found that an association with cigarette smoking was restricted to women (5).”
From Association of ALS with head injury, cigarette smoking and APOE genotypes (2010) · cites this paper as [5]
The lack of association between ALS and cigarette smoking in men observed here is consistent with a previous prospective study that identified an association only in women.
“A previous prospective study (5) identified an association between ALS and cigarette smoking only in women, which is consistent with the lack of association in men observed here.”
From Association of ALS with head injury, cigarette smoking and APOE genotypes (2010) · cites this paper as [5]
Citations
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Effects of gender in amyotrophic lateral sclerosis
McCombe, P. A., & Henderson, R. D. (2010) · Gender Medicine · doi:10.1016/j.genm.2010.11.010 · Cited by 379
Wang, M.-D., Little, J., Gomes, J., Cashman, N. R., & Krewski, D. (2017) · NeuroToxicology · doi:10.1016/j.neuro.2016.06.015 · Cited by 233
Association of ALS with head injury, cigarette smoking and APOE genotypes
Schmidt, S., Kwee, L. C., Allen, K. D., & Oddone, E. Z. (2010) · Journal of the Neurological Sciences · doi:10.1016/j.jns.2010.01.011 · Cited by 117
Fitzgerald, K. C., O'Reilly, É. J., Fondell, E., Falcone, G. J., McCullough, M. L., Park, Y., Kolonel, L. N., & Ascherio, A. (2013) · Annals of Neurology · doi:10.1002/ana.23820 · Cited by 91
Metadata
- Authors
- Weisskopf, M. G.
- Affiliations
- Harvard University (US)
- Corresponding author
- Weisskopf, M. G.
- ORCID
- Weisskopf, M. G.
- Venue
- American Journal of Epidemiology
- Publisher
- Oxford University Press (OUP)
- Published
- 2004-07-01
- Volume
- 160
- Issue
- 1
- Pages
- 26-33
- ISSN
- 0002-9262 (ISSN-L)
- OpenAlex
- W2074671209
- Cited by
- 154
- References
- 0
- Citations by year
- 2026: 1 · 2025: 1 · 2024: 2 · 2023: 4 · 2022: 1 · 2021: 8 · 2020: 8 · 2019: 5 · 2018: 6 · 2017: 5 · 2016: 6 · 2015: 9 · 2014: 5 · 2013: 7 · 2012: 9
- FWCI
- 7.63
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- American Journal of Epidemiology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Clinical Neurology › Amyotrophic Lateral Sclerosis Research
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Smoking Behavior and Cessation
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Chronic Obstructive Pulmonary Disease (COPD) Research
- Keywords
- cigarette smoking, amyotrophic lateral sclerosis, ALS mortality, smoking as risk factor, sex differences
- MeSH terms
- Adult, Amyotrophic Lateral Sclerosis, Death Certificates, Epidemiologic Methods, Female, Humans, Life Style, Male, Middle Aged, Prospective Studies, Surveys and Questionnaires, Risk, Smoking, United States, Incidence, Sex Distribution, International Classification of Diseases
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