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Neurology 2000;54:114
© 2000 American Academy of Neurology
Articles

Smoking habits in multiple system atrophy and progressive supranuclear palsy

N. Vanacore, MD, V. Bonifati, MD, G. Fabbrini, MD, C. Colosimo, MD, R. Marconi, MD, D. Nicholl, MRCP, U. Bonuccelli, MD, F. Stocchi, MD, P. Lamberti, MD, G. Volpe, MD, G. De Michele, MD, I. Iavarone, MSc, P. Bennett, PhD, P. Vieregge, MD, G. Meco, MD and the European Study Group on Atypical Parkinsonisms*

From the Department of Neurosciences (Drs. Vanacore, Bonifati, Fabbrini, Colosimo, Stocchi, and Meco), "La Sapienza" University, Rome, Italy; the Neurology Service (Dr. Marconi), "Misericordia" Hospital, Grosseto, Italy; the University Department of Clinical Neurology (Dr. Nicholl), Edgbaston, Birmingham, UK; the Institute of Neurology (Dr. Bonuccelli), University of Pisa, Italy; the Institute of Neurology (Dr. Lamberti), University of Bari, Italy; the Department of Neurological Sciences (Drs. Volpe and De Michele), "Federico II" University, Naples, Italy; the National Institute of Health (I. Iavarone), Laboratory of Environmental Hygiene, Rome, Italy; the University Department of Psychiatry (Dr. Bennett), Birmingham, UK; and the Department of Neurology (Dr. Vieregge), Medical University of Lübeck, Germany.

Address correspondence and reprint requests to Dr. Nicola Vanacore, Department of Neurosciences, "La Sapienza" University, Viale dell’Università 30, 00185 Rome, Italy.

OBJECTIVE: To evaluate smoking habits in patients with multiple system atrophy (MSA) and progressive supranuclear palsy (PSP) in a multicenter case–control study to determine whether these two forms of atypical parkinsonism share the inverse association with smoking previously found in PD.

BACKGROUND: No epidemiologic studies have been performed on smoking habits in MSA. A previous investigation in PSP revealed no differences in smoking habits between patients and hospital control subjects.

METHODS: Seventy-six MSA patients, 55 PSP patients, 140 PD patients, and 134 healthy control subjects were enrolled consecutively at seven neurologic clinics from January 1, 1994, to July 31, 1998. Detailed information on smoking habits was obtained using a structured questionnaire.

RESULTS: The comparison between frequencies of never-smokers versus ever-smokers (ex-smokers/current smokers; adjusted odds ratio [ORadj], 0.56; 95% CI, 0.29 to 1.06) and a dose–response analysis for never-smokers, moderate smokers (ORadj, 0.64; 95% CI, 0.31 to 1.32), and heavy smokers (ORadj, 0.47; 95% CI, 0.21 to 1.05) suggest that MSA patients smoke less than population control subjects. By contrast, the comparison of frequencies of never-smokers versus ever-smokers (ORadj, 0.91; 95% CI, 0.42 to 1.98) and a dose–response analysis for never-smokers, moderate smokers (ORadj, 0.68; 95% CI, 0.27 to 1.69), and heavy smokers (ORadj, 1.24; CI 95%, 0.51 to 3.06) revealed no differences in smoking habits between PSP patients and population control subjects.

CONCLUSIONS: The fact that the inverse association with smoking found previously in PD is shared by multiple system atrophy but not by progressive supranuclear palsy lends epidemiologic support to the notion that different smoking habits are associated with different groups of neurodegenerative disease.

Key words: Multiple system atrophy—Progressive supranuclear palsy—Smoking






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