1. Moist smokeless tobacco (Snus) use and risk of Parkinson's disease.
- Author
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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, and Ye, Weimin
- Subjects
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 - Abstract
Background: 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.Methods: 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.Results: 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).Conclusions: 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. [ABSTRACT FROM AUTHOR]- Published
- 2017
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