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@article{Gallo:2019:ije/dyy230,
author = {Gallo, V and Vineis, P and Cancellieri, M and Chiodini, P and Barker, RA and Brayne, C and Pearce, N and Vermeulen, R and Panico, S and Bueno-de-Mesquita, B and Vanacore, N and Forsgren, L and Ramat, S and Ardanaz, E and Arriola, L and Peterson, J and Hansson, O and Gavrila, D and Sacerdote, C and Sieri, S and Kühn, T and Katzke, VA and van, der Schouw YT and Kyrozis, A and Masala, G and Mattiello, A and Perneczky, R and Middleton, L and Saracci, R and Riboli, E},
doi = {ije/dyy230},
journal = {International Journal of Epidemiology},
pages = {912--925},
title = {Exploring causality of the association between smoking and Parkinson's disease},
url = {http://dx.doi.org/10.1093/ije/dyy230},
volume = {48},
year = {2019}
}

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TY  - JOUR
AB  - Background: The aim of this paper is to investigate the causality of the inverse association between cigarette smoking and Parkinson's disease (PD). The main suggested alternatives include a delaying effect of smoking, reverse causality or an unmeasured confounding related to a low-risk-taking personality trait. Methods: A total of 715 incident PD cases were ascertained in a cohort of 220 494 individuals from NeuroEPIC4PD, a prospective European population-based cohort study including 13 centres in eight countries. Smoking habits were recorded at recruitment. We analysed smoking status, duration, and intensity and exposure to passive smoking in relation to PD onset. Results: Former smokers had a 20% decreased risk and current smokers a halved risk of developing PD compared with never smokers. Strong dose-response relationships with smoking intensity and duration were found. Hazard ratios (HRs) for smoking <20 years were 0.84 [95% confidence interval (CI) 0.67-1.07], 20-29 years 0.73 (95% CI 0.56-0.96) and >30 years 0.54 (95% CI 0.43-0.36) compared with never smokers. The proportional hazard assumption was verified, showing no change of risk over time, arguing against a delaying effect. Reverse causality was disproved by the consistency of dose-response relationships among former and current smokers. The inverse association between passive smoking and PD, HR 0.70 (95% CI 0.49-0.99) ruled out the effect of unmeasured confounding. Conclusions: These results are highly suggestive of a true causal link between smoking and PD, although it is not clear which is the chemical compound in cigarette smoking responsible for the biological effect.
AU  - Gallo,V
AU  - Vineis,P
AU  - Cancellieri,M
AU  - Chiodini,P
AU  - Barker,RA
AU  - Brayne,C
AU  - Pearce,N
AU  - Vermeulen,R
AU  - Panico,S
AU  - Bueno-de-Mesquita,B
AU  - Vanacore,N
AU  - Forsgren,L
AU  - Ramat,S
AU  - Ardanaz,E
AU  - Arriola,L
AU  - Peterson,J
AU  - Hansson,O
AU  - Gavrila,D
AU  - Sacerdote,C
AU  - Sieri,S
AU  - Kühn,T
AU  - Katzke,VA
AU  - van,der Schouw YT
AU  - Kyrozis,A
AU  - Masala,G
AU  - Mattiello,A
AU  - Perneczky,R
AU  - Middleton,L
AU  - Saracci,R
AU  - Riboli,E
DO  - ije/dyy230
EP  - 925
PY  - 2019///
SN  - 1464-3685
SP  - 912
TI  - Exploring causality of the association between smoking and Parkinson's disease
T2  - International Journal of Epidemiology
UR  - http://dx.doi.org/10.1093/ije/dyy230
UR  - https://www.ncbi.nlm.nih.gov/pubmed/30462234
UR  - https://academic.oup.com/ije/article/48/3/912/5184917
UR  - http://hdl.handle.net/10044/1/65503
VL  - 48
ER  -

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