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American Journal of Epidemiology Advance Access originally published online on January 8, 2009
American Journal of Epidemiology 2009 169(6):678-682; doi:10.1093/aje/kwn388
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American Journal of Epidemiology © The Author 2009. Published by the Johns Hopkins Bloomberg School of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oxfordjournals.org.

ORIGINAL CONTRIBUTIONS

Smoking and Parkinson's Disease: Using Parental Smoking as a Proxy to Explore Causality

Éilis J. O'Reilly, Honglei Chen, Hannah Gardener, Xiang Gao, Michael A. Schwarzschild and Alberto Ascherio

Correspondence to Éilis J. O’Reilly, Departments of Epidemiology and Nutrition, Harvard School of Public Health, 677 Huntington Avenue, Boston, MA 02215 (e-mail: eoreilly{at}hsph.harvard.edu).

Received for publication July 3, 2008. Accepted for publication November 12, 2008.

In epidemiologic studies and in studies of discordant twins, cigarette smoking has been consistently associated with a lower risk of Parkinson's disease, but whether this association is causal remains controversial. Alternatively, an infectious or toxic exposure in childhood or early adulthood could affect both the reward mechanisms that determine smoking behavior and the future risk of Parkinson's disease. If so, parental smoking, commonly established before the birth of the first child, would be unlikely to be related to Parkinson's disease risk. The authors assessed the association between Parkinson's disease and parental smoking during childhood in the Nurses’ Health Study and the Health Professionals Follow-up Study conducted in the United States. During 26 years and 18 years of follow-up, respectively, 455 newly diagnosed Parkinson's disease cases were documented among those who provided information on parental smoking. The age-adjusted, pooled relative rate of Parkinson's disease was 0.73 (95% confidence interval: 0.53, 1.00; P-trend = 0.04) comparing participants who reported that both parents smoked with those who reported that neither did. Adjustment for caffeine and alcohol intake did not materially change the results. If the inverse association between smoking and Parkinson's disease were due to confounding by an environmental factor or were the result of reverse causation, it is unlikely that parental smoking would predict Parkinson's disease.

causality; Parkinson disease; smoking; tobacco smoke pollution


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