Cigarette smoking and risk of MS in multiplex families

Jafari, Naghmeh; Hoppenbrouwers, I A; Hop, Wim C. J.; Breteler, Monique M.B.; Hintzen, Rogier Q.

doi:10.1177/1352458509345907

Cited by 31 publications

(23 citation statements)

References 13 publications

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“…It is to be noted that they collected data on smoking and drinking in adolescence. In a recent case-control study in multiplex families [24], we were not able to show an association of smoking and MS. This was possibly due to the higher genetic susceptibility in the multiplex families, which could obfuscate the role of smoking.…”

Section: Cigarette Smoking and Risk Of Mscontrasting

confidence: 74%

The association between cigarette smoking and multiple sclerosis

Jafari

Hintzen

2011

Journal of the Neurological Sciences

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Genetic factors partially explain the susceptibility of multiple sclerosis (MS) and might even relate to the clinical course. Still, many epidemiological studies point at an important role for environmental factors in MS. Smoking is one of the major candidates. In this review we provide an overview of the epidemiological studies on cigarette smoking and the association on MS risk and MS clinical course. In addition, we discuss the possible biological pathways that may influence neurological damage in MS. Moreover, the relation of smoking with other environmental MS risk factors will be addressed.

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Section: Cigarette Smoking and Risk Of Mscontrasting

confidence: 74%

The association between cigarette smoking and multiple sclerosis

Jafari

Hintzen

2011

Journal of the Neurological Sciences

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“…Since then a number of case-control and population cohort studies have been performed with near universal agreement that smoking cigarettes increases susceptibility to MS [4], [8], [9], [10], [11], [12], [13], [14], [15], [16], [17], [18]. Evidence from New Zealand suggests that smoking behaviour may contribute to the latitudinal distribution of MS risk there [19], [20]…”

Section: Introductionmentioning

confidence: 99%

Smoking and Multiple Sclerosis: An Updated Meta-Analysis

et al. 2011

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BackgroundMultiple sclerosis (MS) is a leading cause of disability in young adults. Susceptibility to MS is determined by environmental exposure on the background of genetic risk factors. A previous meta-analysis suggested that smoking was an important risk factor for MS but many other studies have been published since then.Methods/Principal FindingsWe performed a Medline search to identify articles published that investigated MS risk following cigarette smoking. A total of 14 articles were included in this study. This represented data on 3,052 cases and 457,619 controls. We analysed these studies in both a conservative (limiting our analysis to only those where smoking behaviour was described prior to disease onset) and non-conservative manner. Our results show that smoking is associated with MS susceptibility (conservative: risk ratio (RR) 1.48, 95% confidence interval (CI) 1.35–1.63, p<10−15; non-conservative: RR 1.52, 95% CI 1.39–1.66, p<10−19). We also analysed 4 studies reporting risk of secondary progression in MS and found that this fell just short of statistical significance with considerable heterogeneity (RR 1.88, 95% CI 0.98–3.61, p = 0.06).DiscussionOur results demonstrate that cigarette smoking is important in determining MS susceptibility but the effect on the progression of disease is less certain. Further work is needed to understand the mechanism behind this association and how smoking integrates with other established risk factors.

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“…A further metaanalysis confirms this association by pooling data from 14 studies, reporting a risk ratio of nearly 1.5 [13] . However, the only study with the same design as ours, com- paring MS patients with their healthy siblings, could not show any association between smoking and the risk of MS [14] . This difference might be because of their small sample size in combination with reduced statistical power due to overmatching.…”

Section: Discussionmentioning

confidence: 86%

Cigarette Smoking and the Risk of Multiple Sclerosis: A Sibling Case-Control Study in Isfahan, Iran

Maghzi

Etemadifar²,

Heshmat-Ghahdarijani³

et al. 2011

Neuroepidemiology

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Aims: We aimed to study the smoking habits of multiple sclerosis (MS) patients and their healthy siblings in Isfahan province in Iran. Methods: MS patients registered with the Isfahan MS society database were compared to their healthy siblings who served as controls. Data regarding the smoking habits of patients and their siblings were collected using a specially designed questionnaire. Conditional logistic regression was adopted to analyze the association of smoking with the risk of MS, adjusting for age and sex. Results: There were 1,606 participants with 516 cases and 1,090 controls. After adjustments for age and sex, subjects who were ever-smokers had a significant risk of developing MS [odds ratio (OR) 2.67; 95% confidence interval (CI) 1.70–4.21; p <0.001]. Past smokers (OR 8.83; 95% CI 3.98–19.60; p < 0.001) and current smokers (OR 1.84; 95% CI 1.10–3.10; p = 0.021) had a significant risk for developing MS. Disease progression (current expanded disability status scale/disease duration) was not different between smokers and nonsmokers (0.54 ±0.42 vs. 0.49 ±0.48; p = 0.61). Conclusion: Using a sibling pair method our data confirm the association between smoking and MS. A degree of confounding due to overmatching between siblings was unavoidable, but any bias would be conservative and should have lessened the effect of smoking.

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Cigarette smoking and risk of MS in multiplex families

Cited by 31 publications

References 13 publications

The association between cigarette smoking and multiple sclerosis

The association between cigarette smoking and multiple sclerosis

Smoking and Multiple Sclerosis: An Updated Meta-Analysis

Cigarette Smoking and the Risk of Multiple Sclerosis: A Sibling Case-Control Study in Isfahan, Iran

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