Hernán M A, Zhang S M, Rueda-deCastro A M, Colditz G A, Speizer F E, Ascherio A
Department of Epidemiology, Harvard School of Public Health, Boston, MA 02115, USA.
Ann Neurol. 2001 Dec;50(6):780-6. doi: 10.1002/ana.10028.
An inverse association between cigarette smoking and idiopathic Parkinson's disease has been reported in several retrospective studies, but prospective evidence is available only for men. We assessed the association between the incidence of Parkinson's disease and smoking in two large prospective cohort studies comprising men and women. New cases of Parkinson's disease were identified in the Nurses' Health Study for 1976-1996, and in the Health Professionals Follow-up Study for 1986-1996. Smoking history was assessed at baseline and updated on subsequent biennial questionnaires. In women, the age-adjusted rate ratios (95% confidence intervals) for Parkinson's disease relative to never-smokers were 0.7 (0.5, 1.0) for past smokers, and 0.4 (0.2, 0.7) for current smokers. In men, the age-adjusted rate ratios for Parkinson's disease relative to never-smokers were 0.5 (0.4, 0.7) for past smokers, and 0.3 (0.1, 0.8) for current smokers. In both cohorts, the strength of the association decreased with time since quitting (among past smokers), increased with number of cigarettes per day (among current smokers), and increased with pack-years of smoking. These prospective findings confirm that an inverse association between smoking and the incidence of Parkinson's disease exists in both men and women.
几项回顾性研究报告了吸烟与特发性帕金森病之间存在负相关，但前瞻性证据仅适用于男性。我们在两项纳入男性和女性的大型前瞻性队列研究中评估了帕金森病发病率与吸烟之间的关联。在护士健康研究（1976 - 1996年）和卫生专业人员随访研究（1986 - 1996年）中确定了帕金森病的新病例。在基线时评估吸烟史，并在随后的两年一次问卷调查中更新。在女性中，相对于从不吸烟者，帕金森病的年龄调整率比（95%置信区间），既往吸烟者为0.7（0.5，1.0），当前吸烟者为0.4（0.2，0.7）。在男性中，相对于从不吸烟者，帕金森病的年龄调整率比，既往吸烟者为0.5（0.4，0.7），当前吸烟者为0.3（0.1，0.8）。在两个队列中，关联强度随着戒烟时间的延长（在既往吸烟者中）而降低，随着每日吸烟量的增加（在当前吸烟者中）而增加，并且随着吸烟包年数的增加而增加。这些前瞻性研究结果证实，吸烟与帕金森病发病率之间的负相关在男性和女性中均存在。
