Hedström A K, Olsson T, Alfredsson L
Institute of Environmental Medicine, Karolinska Institute, Sweden
Neuroimmunology Unit, Department of clinical neuroscience and Center for Molecular Medicine, Karolinska Institute at Karolinska University Hospital, Sweden.
Mult Scler. 2016 Jul;22(8):1021-6. doi: 10.1177/1352458515609794. Epub 2015 Oct 12.
Both smoking and exposure to passive smoking have repeatedly been associated with increased multiple sclerosis (MS) risk, but have never before been studied together. We assessed the public health impact of these factors.
In a Swedish population-based case-control study (2455 cases, 5336 controls), we calculated odds ratios of developing MS associated with different categories of tobacco smoke exposure, together with 95% confidence intervals, by using logistic regression. The excess proportion of cases attributable to smoking and passive smoking was calculated as a percentage.
Both smoking and exposure to passive smoking contribute to MS risk in a dose-dependent manner. At the population level, 20.4% of all cases were attributable to smoke exposure. Among subjects carrying the genetic risk factor HLA-DRB115 but lacking HLA-A02, 41% of the MS cases were attributable to smoking.
From a public health perspective, the impact of smoking and passive smoking on MS risk is considerable. Preventive measures in order to reduce tobacco smoke exposure are, therefore, essential. In particular, individuals with a history of MS in the family should be informed regarding the impact of smoking on the risk of MS, and the importance of preventing their children from being exposed to passive smoke.
吸烟和接触二手烟均多次被认为与多发性硬化症（MS）风险增加有关，但此前从未对二者进行过共同研究。我们评估了这些因素对公共卫生的影响。
在一项基于瑞典人群的病例对照研究（2455例病例，5336例对照）中，我们通过逻辑回归计算了与不同类别烟草烟雾暴露相关的患MS的比值比以及95%置信区间。将归因于吸烟和二手烟的病例超额比例计算为百分比。
吸烟和接触二手烟均以剂量依赖的方式增加MS风险。在人群层面，所有病例中有20.4%可归因于烟雾暴露。在携带遗传风险因素HLA-DRB115但缺乏HLA-A02的受试者中，41%的MS病例可归因于吸烟。
从公共卫生角度来看，吸烟和二手烟对MS风险的影响相当大。因此，采取预防措施以减少烟草烟雾暴露至关重要。特别是，有MS家族病史的个体应了解吸烟对MS风险的影响，以及防止其子女接触二手烟的重要性。
