Epidemiology Branch, National Institute of Environmental Health Sciences, 111 T.W. Alexander Dr., PO Box 12233, Mail drop A3-05, Research Triangle Park, NC 27709, USA.
Neurology. 2010 Mar 16;74(11):878-84. doi: 10.1212/WNL.0b013e3181d55f38. Epub 2010 Mar 10.
To evaluate the relative importance of smoking duration vs intensity in reducing the risk of Parkinson disease (PD).
The study included 305,468 participants of the NIH-AARP Diet and Health cohort, of whom 1,662 had a PD diagnosis after 1995. We estimated odds ratios (OR) and 95% confidence intervals from multivariate logistic regression models.
Compared with never smokers, the multivariate ORs were 0.78 for past smokers and 0.56 for current smokers. Among past smokers, a monotonic trend toward lower PD risk was observed for all indicators of more smoking. Stratified analyses indicated that smoking duration was associated with lower PD risk within fixed intensities of smoking. For example, compared with never smokers, the ORs among past smokers who smoked >20 cigarettes/day were 0.96 for 1-9 years of smoking, 0.78 for 10-19 years, 0.64 for 20-29 years, and 0.59 for 30 years or more (p for trend = 0.001). In contrast, at fixed duration, the typical number of cigarettes smoked per day in general was not related to PD risk. Close examination of smoking behaviors in early life showed that patients with PD were less likely to be smokers at each age period, but if they smoked, they smoked similar numbers of cigarettes per day as individuals without PD.
This large study suggests that long-term smoking is more important than smoking intensity in the smoking-Parkinson disease relationship.
评估吸烟持续时间与吸烟强度在降低帕金森病（PD）风险方面的相对重要性。
该研究纳入了 NIH-AARP 饮食与健康队列的 305468 名参与者，其中 1995 年后有 1662 人被诊断为 PD。我们采用多变量逻辑回归模型来估计比值比（OR）和 95%置信区间。
与从不吸烟者相比，既往吸烟者的多变量 OR 为 0.78，当前吸烟者的 OR 为 0.56。在既往吸烟者中，所有吸烟量指标均显示出 PD 风险呈单调下降趋势。分层分析表明，在固定的吸烟强度内，吸烟持续时间与较低的 PD 风险相关。例如，与从不吸烟者相比，每天吸烟>20 支的既往吸烟者中，吸烟 1-9 年的 OR 为 0.96，吸烟 10-19 年的 OR 为 0.78，吸烟 20-29 年的 OR 为 0.64，吸烟 30 年或以上的 OR 为 0.59（趋势检验的 p 值=0.001）。相比之下，在固定的吸烟持续时间内，每天吸烟的典型支数与 PD 风险无关。对早期生活中的吸烟行为进行仔细检查后发现，PD 患者在每个年龄段都不太可能吸烟，但如果他们吸烟，他们每天吸烟的支数与没有 PD 的人相似。
这项大型研究表明，长期吸烟比吸烟强度在吸烟与帕金森病的关系中更为重要。
