Ibrahim Abdollahpour1, Saharnaz Nedjat2, Mohammad Ali Sahraian3, Mohammad Ali Mansournia4, Petr Otahal5, Ingrid van der Mei5. 1. Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran/School of Public Health, Arak University of Medical Sciences, Arak, Iran. 2. Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran/Knowledge Utilization Research Center, Tehran University of Medical Sciences, Tehran, Iran. 3. MS Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran. 4. Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran. 5. Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS, Australia.
Abstract
BACKGROUND: While cigarette and passive smoking have been identified as modifiable risk factors for multiple sclerosis (MS), there is no report regarding Waterpipe smoking-MS association. OBJECTIVE: We examined the association of Waterpipe, tobacco, and passive smoking with MS. METHODS: Population-based incident case-control study in Iran with 547 incident cases and 1057 general population controls (7 August 2013-17 February 2015). Logistic regression model was used. Multiplicative along with additive interaction was assessed using product term and Synergy Index (SI), respectively, and the population attributable fractions (PAFs) were calculated. RESULTS: Having ever smoked Waterpipe, tobacco, or being exposed to passive smoking were all significantly associated with MS (odds ratio (OR) = 1.77 (1.36-2.31), OR = 1.69 (1.24-2.31), and OR = 1.85 (1.48-2.32), respectively). Clear dose-response associations were observed with the duration exposed ( p < 0.001 for all three) and the amount smoked ( p < 0.001 for Waterpipe and tobacco). Those who had all three types of smoking had an odds that was 4.1 times higher than those without any type. The three types of smoking jointly contributed to 30.9% of the MS incidence. CONCLUSION: We identified Waterpipe smoking as a novel risk factor for MS. Given the global increase in Waterpipe smoking, especially among young adults, this finding reinforces the need for public health interventional and educational programs to combat this global increase.
BACKGROUND: While cigarette and passive smoking have been identified as modifiable risk factors for multiple sclerosis (MS), there is no report regarding Waterpipe smoking-MS association. OBJECTIVE: We examined the association of Waterpipe, tobacco, and passive smoking with MS. METHODS: Population-based incident case-control study in Iran with 547 incident cases and 1057 general population controls (7 August 2013-17 February 2015). Logistic regression model was used. Multiplicative along with additive interaction was assessed using product term and Synergy Index (SI), respectively, and the population attributable fractions (PAFs) were calculated. RESULTS: Having ever smoked Waterpipe, tobacco, or being exposed to passive smoking were all significantly associated with MS (odds ratio (OR) = 1.77 (1.36-2.31), OR = 1.69 (1.24-2.31), and OR = 1.85 (1.48-2.32), respectively). Clear dose-response associations were observed with the duration exposed ( p < 0.001 for all three) and the amount smoked ( p < 0.001 for Waterpipe and tobacco). Those who had all three types of smoking had an odds that was 4.1 times higher than those without any type. The three types of smoking jointly contributed to 30.9% of the MS incidence. CONCLUSION: We identified Waterpipe smoking as a novel risk factor for MS. Given the global increase in Waterpipe smoking, especially among young adults, this finding reinforces the need for public health interventional and educational programs to combat this global increase.
Authors: Ibrahim Abdollahpour; Zahra Golestannejad; Yahya Salimi; Saharnaz Nedjat; Isabel Aguilar-Palacioc; Mohammad Ali Mansournia; Maximilian de Courten Journal: Tob Use Insights Date: 2022-05-15
Authors: Emmanuelle Waubant; Robyn Lucas; Ellen Mowry; Jennifer Graves; Tomas Olsson; Lars Alfredsson; Annette Langer-Gould Journal: Ann Clin Transl Neurol Date: 2019-08-07 Impact factor: 4.511