Am J Epidemiol 2004; 160:26-33.
Copyright © 2004 by the Johns
Hopkins Bloomberg School of Public Health
ORIGINAL CONTRIBUTIONS |
Prospective Study of Cigarette Smoking and Amyotrophic Lateral Sclerosis
1 Department of Nutrition, Harvard School of Public Health, Boston, MA.
2 Department of Environmental Health, Harvard School of Public Health, Boston, MA.
3 Epidemiology and Surveillance Research, American Cancer Society, Atlanta, GA.
4 Neurology Clinical Trial Unit, Massachusetts General Hospital, Harvard Medical School, Boston, MA.
5 Department of Epidemiology, Harvard School of Public Health, Boston, MA.
6 The Channing Laboratory, Department of Medicine, Harvard Medical School and Brigham and Women’s Hospital, Boston, MA.
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.
amyotrophic lateral sclerosis; mortality; motor neuron disease; prospective studies
Abbreviations: Abbreviations: ALS, amyotrophic lateral sclerosis; CI, confidence interval; CPS II, Cancer Prevention Study II; ICD-9, International Classification of Diseases, Ninth Revision.
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