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May Create an Added Risk for Alzheimer’s Disease
all studies of the relationship between smoking and Alzheimer’s
disease are equal, according to a recent analysis performed by the
University of California San Francisco (UCSF), which found indications
that smoking cigarettes may be a significant risk factor for the
disease based upon non-tobacco industry-affiliated studies.
UCSF researchers analyzed 43 studies performed by independent organizations and
those affiliated with the tobacco industry published between 1984 and 2000 to
analyze the results linking Alzheimer’s disease and smoking.
After controlling for study design, quality of the journals, time of publication,
and tobacco industry affiliation of the authors, the UCSF research team found
an association between tobacco industry affiliation and the conclusions of individual
Industry-affiliated studies indicated that smoking protects against the development
of Alzheimer’s disease, while independent studies showed that smoking increased
the risk of developing the disease.
The UCSF findings were published in the online January 2009 issue of the Journal
of Alzheimer’s Disease.
Researchers from UCSF hope the study provides further insight into risk factors
for Alzheimer’s disease.
“For many years, published studies and popular media have perpetuated the
myth that smoking is protective against the development of Alzheimer’s
disease,” explained Janine K. Cataldo, Ph.D., RN, assistant professor in
the UCSF School of Nursing and lead author of the study.
“The disease’s impact on quality of life and health care costs continues
to rise,” Catalado continued. “It is therefore critical that we better
understand its causes, in particular, the role of cigarette smoking.”
According to the Alzheimer’s Association, 5.3 million Americans currently
have the disease, and that number will escalate rapidly as the baby boom generation
ages. Alzheimer’s disease also triples health care costs for Americans
aged 65 and older, the organization states.
UCSF researchers found that one-fourth of the 43 studies analyzed had an affiliation
with the tobacco industry and compared those results with the findings of the
non-tobacco industry-affiliated studies.
The UCSF team determined that the average risk of a smoker developing Alzheimer’s
disease, based on studies without tobacco industry affiliation, was estimated
to be 1.72, meaning that smoking nearly doubled the risk of Alzheimer’s
In contrast, UCSF researchers found that studies authored by individuals with
tobacco industry affiliations showed a risk factor of .86 (less than one), suggesting
that smoking protects against the illness.
When all studies were considered together, the risk factor for developing Alzheimer’s
disease from smoking was essentially neutral at a statistically insignificant
Previous reviews of the association between smoking and Alzheimer’s disease
have not controlled for study design and author affiliation with the tobacco
industry, according to Cataldo.
To determine if study authors had connections to the tobacco industry, the UCSF
team analyzed 877 previously secret tobacco industry documents.
The researchers used an inclusive definition of “tobacco industry affiliation” and
examined authors’ current or past funding, employment, paid consultation
and collaboration or co-authorship on a study with someone who had current or
previous tobacco industry funding within 10 years of publication.
“We know that industry-sponsored research is more likely to reach conclusions
favorable to the sponsor,” observed Stanton A. Glantz, Ph.D., of the UCSF
Department of Medicine and a study co-author.
“Our findings point to the ongoing corrosive nature of tobacco industry
funding and point to the need for academic institutions to decline tobacco industry
funding to protect the research process.”
The UCSF research was supported by grants from the California Tobacco Related
Disease Research Program, the National Cancer Institute and the National Institute
on Drug Abuse.
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