UK Case control study of smoking and risk of Amyotrophic Lateral Sclerosis

Sarah Catherine Martin; Ashley Richard Jones; Alfredo Iacoangeli; Ahmad Al Khleifat; Mohamad Oumar; Pamela J Shaw; Christopher Edward Dennistoun Shaw; Karen E. Morrison; Robin E Wootton; George Davey Smith; N Pearce; Ammar Al-Chalabi

doi:10.1080/21678421.2019.1706580

UK Case control study of smoking and risk of Amyotrophic Lateral Sclerosis

Sarah Catherine Martin, Ashley Richard Jones, Alfredo Iacoangeli, Ahmad Al Khleifat, Mohamad Oumar, Pamela J Shaw, Christopher Edward Dennistoun Shaw, Karen E. Morrison, Robin E Wootton, George Davey Smith, N Pearce, Ammar Al-Chalabi

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Abstract

Introduction: Susceptibility to amyotrophic lateral sclerosis (ALS) is associated with smoking in some studies, but it is not clear which aspect of smoking behavior is related. Using detailed records of lifetime smoking we investigated the relationship between smoking and ALS in a UK population. Methods: In this retrospective case-control study, smoking status was collected using environmental questionnaires from people diagnosed with ALS between 2008 and 2013 and from age, sex and geographically matched controls. Categorical measures of smoking behavior were: smoking at the time of survey and smoking initiation; continuous measures were intensity (cigarettes per day), duration (years from starting to stopping or time of survey), cigarette pack years, and comprehensive smoking index (CSI), a measure of lifetime smoking. We used logistic regression to assess the risk of ALS with different combinations of smoking variables adjusted for age at survey, gender, level of education, smoking status and alcohol initiation, selecting the best model using the Akaike Information Criterion. Results: There were 388 records with full smoking history. The best-fitting model used CSI and smoking status at the time of survey. We found a weak association between current smoking and risk of ALS, OR 3.63 (95% CI 1.02–13.9) p value 0.05. Increase in CSI score did not increase risk of ALS: OR 0.81 (95% CI 0.58–1.11) p value 0.2.Conclusion: There is weak evidence of a positive effect of current smoking on the risk of ALS which does not show dose-dependence with higher levels of lifetime smoking and maybe a false positive result.

Original language	English
Pages (from-to)	222-227
Number of pages	6
Journal	Amyotrophic lateral sclerosis & frontotemporal degeneration
Volume	21
Issue number	3-4
DOIs	https://doi.org/10.1080/21678421.2019.1706580
Publication status	Published - 17 Apr 2020

Keywords

Amyotrophic lateral sclerosis
case control
smoking

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10.1080/21678421.2019.1706580

UK Case control study_OPIE-MARTIN_Accepted30November2029_GOLD AAM Accepted author manuscript, 70.7 KB

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Martin, S. C., Jones, A. R., Iacoangeli, A., Al Khleifat, A., Oumar, M., Shaw, P. J., Shaw, C. E. D., Morrison, K. E., Wootton, R. E., Smith, G. D., Pearce, N., & Al-Chalabi, A. (2020). UK Case control study of smoking and risk of Amyotrophic Lateral Sclerosis. Amyotrophic lateral sclerosis & frontotemporal degeneration, 21(3-4), 222-227. https://doi.org/10.1080/21678421.2019.1706580

@article{240476b2f6b24d1aaf5f962728acc1d2,

title = "UK Case control study of smoking and risk of Amyotrophic Lateral Sclerosis",

abstract = "Introduction: Susceptibility to amyotrophic lateral sclerosis (ALS) is associated with smoking in some studies, but it is not clear which aspect of smoking behavior is related. Using detailed records of lifetime smoking we investigated the relationship between smoking and ALS in a UK population. Methods: In this retrospective case-control study, smoking status was collected using environmental questionnaires from people diagnosed with ALS between 2008 and 2013 and from age, sex and geographically matched controls. Categorical measures of smoking behavior were: smoking at the time of survey and smoking initiation; continuous measures were intensity (cigarettes per day), duration (years from starting to stopping or time of survey), cigarette pack years, and comprehensive smoking index (CSI), a measure of lifetime smoking. We used logistic regression to assess the risk of ALS with different combinations of smoking variables adjusted for age at survey, gender, level of education, smoking status and alcohol initiation, selecting the best model using the Akaike Information Criterion. Results: There were 388 records with full smoking history. The best-fitting model used CSI and smoking status at the time of survey. We found a weak association between current smoking and risk of ALS, OR 3.63 (95% CI 1.02–13.9) p value 0.05. Increase in CSI score did not increase risk of ALS: OR 0.81 (95% CI 0.58–1.11) p value 0.2.Conclusion: There is weak evidence of a positive effect of current smoking on the risk of ALS which does not show dose-dependence with higher levels of lifetime smoking and maybe a false positive result.",

keywords = "Amyotrophic lateral sclerosis, case control, smoking",

author = "Martin, {Sarah Catherine} and Jones, {Ashley Richard} and Alfredo Iacoangeli and {Al Khleifat}, Ahmad and Mohamad Oumar and Shaw, {Pamela J} and Shaw, {Christopher Edward Dennistoun} and Morrison, {Karen E.} and Wootton, {Robin E} and Smith, {George Davey} and N Pearce and Ammar Al-Chalabi",

year = "2020",

month = apr,

day = "17",

doi = "10.1080/21678421.2019.1706580",

language = "English",

volume = "21",

pages = "222--227",

journal = "Amyotrophic lateral sclerosis & frontotemporal degeneration",

issn = "2167-8421",

publisher = "Taylor & Francis",

number = "3-4",

}

Martin, SC , Jones, AR , Iacoangeli, A , Al Khleifat, A, Oumar, M, Shaw, PJ, Shaw, CED, Morrison, KE, Wootton, RE, Smith, GD, Pearce, N & Al-Chalabi, A 2020, 'UK Case control study of smoking and risk of Amyotrophic Lateral Sclerosis', Amyotrophic lateral sclerosis & frontotemporal degeneration, vol. 21, no. 3-4, pp. 222-227. https://doi.org/10.1080/21678421.2019.1706580

TY - JOUR

T1 - UK Case control study of smoking and risk of Amyotrophic Lateral Sclerosis

AU - Martin, Sarah Catherine

AU - Jones, Ashley Richard

AU - Iacoangeli, Alfredo

AU - Al Khleifat, Ahmad

AU - Oumar, Mohamad

AU - Shaw, Pamela J

AU - Shaw, Christopher Edward Dennistoun

AU - Morrison, Karen E.

AU - Wootton, Robin E

AU - Smith, George Davey

AU - Pearce, N

AU - Al-Chalabi, Ammar

PY - 2020/4/17

Y1 - 2020/4/17

N2 - Introduction: Susceptibility to amyotrophic lateral sclerosis (ALS) is associated with smoking in some studies, but it is not clear which aspect of smoking behavior is related. Using detailed records of lifetime smoking we investigated the relationship between smoking and ALS in a UK population. Methods: In this retrospective case-control study, smoking status was collected using environmental questionnaires from people diagnosed with ALS between 2008 and 2013 and from age, sex and geographically matched controls. Categorical measures of smoking behavior were: smoking at the time of survey and smoking initiation; continuous measures were intensity (cigarettes per day), duration (years from starting to stopping or time of survey), cigarette pack years, and comprehensive smoking index (CSI), a measure of lifetime smoking. We used logistic regression to assess the risk of ALS with different combinations of smoking variables adjusted for age at survey, gender, level of education, smoking status and alcohol initiation, selecting the best model using the Akaike Information Criterion. Results: There were 388 records with full smoking history. The best-fitting model used CSI and smoking status at the time of survey. We found a weak association between current smoking and risk of ALS, OR 3.63 (95% CI 1.02–13.9) p value 0.05. Increase in CSI score did not increase risk of ALS: OR 0.81 (95% CI 0.58–1.11) p value 0.2.Conclusion: There is weak evidence of a positive effect of current smoking on the risk of ALS which does not show dose-dependence with higher levels of lifetime smoking and maybe a false positive result.

AB - Introduction: Susceptibility to amyotrophic lateral sclerosis (ALS) is associated with smoking in some studies, but it is not clear which aspect of smoking behavior is related. Using detailed records of lifetime smoking we investigated the relationship between smoking and ALS in a UK population. Methods: In this retrospective case-control study, smoking status was collected using environmental questionnaires from people diagnosed with ALS between 2008 and 2013 and from age, sex and geographically matched controls. Categorical measures of smoking behavior were: smoking at the time of survey and smoking initiation; continuous measures were intensity (cigarettes per day), duration (years from starting to stopping or time of survey), cigarette pack years, and comprehensive smoking index (CSI), a measure of lifetime smoking. We used logistic regression to assess the risk of ALS with different combinations of smoking variables adjusted for age at survey, gender, level of education, smoking status and alcohol initiation, selecting the best model using the Akaike Information Criterion. Results: There were 388 records with full smoking history. The best-fitting model used CSI and smoking status at the time of survey. We found a weak association between current smoking and risk of ALS, OR 3.63 (95% CI 1.02–13.9) p value 0.05. Increase in CSI score did not increase risk of ALS: OR 0.81 (95% CI 0.58–1.11) p value 0.2.Conclusion: There is weak evidence of a positive effect of current smoking on the risk of ALS which does not show dose-dependence with higher levels of lifetime smoking and maybe a false positive result.

KW - Amyotrophic lateral sclerosis

KW - case control

KW - smoking

UR - http://www.scopus.com/inward/record.url?scp=85083652381&partnerID=8YFLogxK

U2 - 10.1080/21678421.2019.1706580

DO - 10.1080/21678421.2019.1706580

M3 - Article

SN - 2167-8421

VL - 21

SP - 222

EP - 227

JO - Amyotrophic lateral sclerosis & frontotemporal degeneration

JF - Amyotrophic lateral sclerosis & frontotemporal degeneration

IS - 3-4

ER -

UK Case control study of smoking and risk of Amyotrophic Lateral Sclerosis

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