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Cited by 117Amyotrophic Lateral Sclerosis ResearchSmoking Behavior and CessationParkinson's Disease Mechanisms and Treatments

Smoking and the risk of amyotrophic lateral sclerosis: a systematic review and meta-analysis

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Alonso, A., Logroscino, G., Hernan, M. A.·2010·Journal of Neurology, Neurosurgery & Psychiatry
DOI 10.1136/jnnp.2009.180232
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Abstract

BACKGROUND: Epidemiologic studies have provided inconsistent results on the association of cigarette smoking with the incidence of amyotrophic lateral sclerosis (ALS). To summarise published evidence and explore sources of heterogeneity, we conducted a systematic review and meta-analysis of studies that evaluated this association. METHODS: Published studies evaluating the association of smoking with incidence of ALS were searched in bibliographic databases, with relevant information collected from each article. A random effects approach was used to pool the relative rate (RR) estimates from different studies. Between study heterogeneity was explored with a meta-regression approach. RESULTS: 18 publications reported associations between smoking and ALS risk in 15 case control studies and five cohort studies. The pooled RR (95% CI) of ALS was 1.28 (0.97 to 1.68) for current versus never smokers and 1.12 (0.98 to 1.27) for ever versus never smokers. The study specifics RRs were heterogeneous (p<0.01). The proportion of women in the study population explained 46% of between study variability. The estimated RR (95% CI) of ALS for ever versus never smokers was 0.86 (0.71 to 1.03) in men and 1.66 (1.31 to 2.10) in women. INTERPRETATION: This meta-analysis does not support an overall strong association of smoking with ALS risk but suggests that smoking might be associated with a higher risk of ALS in women.

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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 [12]

    The Results (page not available in our copy) report that the smoking–ALS association varied by sex and was weakly associated with participants’ mean age. The paper does not report that genetic factors modify the association, and its analysis concerns smoking rather than environmental risk factors generally. (LLM, conf=0.87)

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  • Other studies, including a meta-analysis, suggested that smoking is not associated with the risk for ALS or risk of death after ALS diagnosis.

    “Nevertheless, other studies, including a meta-analysis, suggested that smoking is not associated with the risk for ALS [11, 12] or risk of death after ALS diagnosis [13].”

    From Lifestyle and medical conditions in relation to ALS risk and progression—an introduction to the Swedish ALSrisc Study (2024) · cites this paper as [12]

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Research works printed but not linked: 34

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Authors
Alonso, A., Logroscino, G., & Hernan, M. A.
Affiliations
University of Bari Aldo Moro (IT)
ORCID
Logroscino, G.
Venue
Journal of Neurology, Neurosurgery & Psychiatry
Publisher
BMJ
Published
2010-07-16
Volume
81
Issue
11
Pages
1249-1252
ISSN
0022-3050 (ISSN-L)
DOI
10.1136/jnnp.2009.180232
OpenAlex
W1993018817
Cited by
117
References
0
Citations by year
2026: 4 · 2025: 3 · 2024: 5 · 2023: 3 · 2022: 6 · 2021: 6 · 2020: 5 · 2019: 11 · 2018: 11 · 2017: 6 · 2016: 15 · 2015: 12 · 2014: 6 · 2013: 9 · 2012: 6
FWCI
0.96
Type
journal article
Language
en
Open access
Locations
  • Journal of Neurology Neurosurgery & Psychiatry (publishedVersion)
  • PubMed (publishedVersion)
  • HighWire Press Open Archive (submittedVersion)
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, cigarette smoking, ALS risk, sex differences, study heterogeneity
MeSH terms
Amyotrophic Lateral Sclerosis, Female, Humans, Male, Risk Factors, Smoking, Incidence, Sex Distribution

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