Smoking habits in multiple system atrophy and progressive supranuclear palsy

Objective: To evaluate smoking habits in patients with multiple system atro phy (MSA) and progressive supranuclear palsy (PSP) in a multicenter case-co ntrol study to determine whether these two forms of atypical parkinsonism s hare the inverse association with smoking previously found in PD. Backgroun d: No epidemiologic studies have been performed on smoking habits in MSA. A previous investigation in PSP revealed no differences in smoking habits be tween patients and hospital control subjects. Methods: Seventy-six MSA pati ents, 55 PSP patients, 140 PD patients, and 134 healthy control subjects we re enrolled consecutively at seven neurologic clinics from January 1, 1994, to July 31, 1998. Detailed information on smoking habits was obtained usin g a structured questionnaire. Results: The comparison between frequencies o f never-smokers versus ever-smokers (ex-smokers/current smokers; adjusted o dds 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), a nd heavy smokers (ORadj, 0.47; 95% CI, 0.21 to 1.05) suggest that MSA patie nts smoke less than population control subjects. By contrast, the compariso n 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 smo kers (ORadj, 0.68; 95% CI, 0.21 to 1.69), and heavy smokers (ORadj, 1.24; C I 95%, 0.51 to 3.06) revealed no differences in smoking habits between PSP patients and population control subjects. Conclusions: The fact that the in verse association with smoking found previously in PD is shared by multiple system atrophy but not by progressive supranuclear palsy lends epidemiolog ic support to the notion that different smoking habits are associated with different groups of neurodegenerative disease.