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- Title
Moist smokeless tobacco (Snus) use and risk of Parkinson's disease.
- Authors
Fei Yang; Pedersen, Nancy L.; Weimin Ye; Zhiwei Liu; Norberg, Margareta; Forsgren, Lars; Lagerros, Ylva Trolle; Bellocco, Rino; Alfredsson, Lars; Knutsson, Anders; Jansson, Jan-Håkan; Wennberg, Patrik; Galanti, Maria Rosaria; Lager, Anton C. J.; Araghi, Marzieh; Lundberg, Michael; Magnusson, Cecilia; Wirdefeldt, Karin; Yang, Fei; Ye, Weimin
- Abstract
<bold>Background: </bold>Cigarette smoking is associated with a lower risk of Parkinson's disease. It is unclear what constituent of tobacco smoke may lower the risk. Use of Swedish moist smokeless tobacco (snus) can serve as a model to disentangle what constituent of tobacco smoke may lower the risk. The aim of this study was to determine whether snus use was associated with a lower risk of Parkinson's disease.<bold>Methods: </bold>Individual participant data were collected from seven prospective cohort studies, including 348 601 men. We used survival analysis with multivariable Cox regression to estimate study-specific relative risk of Parkinson's disease due to snus use, and random-effects models to pool estimates in a meta-analysis. The primary analyses were restricted to never-smokers to eliminate the potential confounding effect of tobacco smoking.<bold>Results: </bold>During a mean follow-up time of 16.1 years, 1199 incident Parkinson's disease cases were identified. Among men who never smoked, ever-snus users had about 60% lower Parkinson's disease risk compared with never-snus users [pooled hazard ratio (HR) 0.41, 95% confidence interval (CI) 0.28-0.61]. The inverse association between snus use and Parkinson's disease risk was more pronounced in current (pooled HR 0.38, 95% CI 0.23-0.63), moderate-heavy amount (pooled HR 0.41, 95% CI 0.19-0.90) and long-term snus users (pooled HR 0.44, 95% CI 0.24-0.83).<bold>Conclusions: </bold>Non-smoking men who used snus had a substantially lower risk of Parkinson's disease. Results also indicated an inverse dose-response relationship between snus use and Parkinson's disease risk. Our findings suggest that nicotine or other components of tobacco leaves may influence the development of Parkinson's disease.
- Subjects
SWEDEN; PARKINSON'S disease; BRAIN diseases; TOBACCO analysis; SNUS (Tobacco); PHYSIOLOGICAL effects of nicotine; LONGITUDINAL method; META-analysis; MULTIVARIATE analysis; SELF-evaluation; SMOKELESS tobacco; TOBACCO; PROPORTIONAL hazards models
- Publication
International Journal of Epidemiology, 2017, Vol 46, Issue 3, p872
- ISSN
0300-5771
- Publication type
journal article
- DOI
10.1093/ije/dyw294