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Moist smokeless tobacco (Snus) use and risk of Parkinsons disease

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Author list: Knutsson, Anders
Publication year: 2017
Start page: 872
End page: 880
Number of pages: 9
ISSN: 0300-5771
View additional information: View in Web of Science™

Abstract

Background: Cigarette smoking is associated with a lower risk of Parkinsons 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 Parkinsons 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 Parkinsons 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 Parkinsons disease cases were identified. Among men who never smoked, ever-snus users had about 60% lower Parkinsons 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 Parkinsons 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 Parkinsons disease. Results also indicated an inverse dose-response relationship between snus use and Parkinsons disease risk. Our findings suggest that nicotine or other components of tobacco leaves may influence the development of Parkinsons disease.


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