Influence of cigarette smoking on ALS outcome: A population-based study

Andrea Calvo, Antonio Canosa, Davide Bertuzzo, Paolo Cugnasco, Luca Solero, Marinella Clerico, Stefania De Mercanti, Enrica Bersano, Stefania Cammarosano, Antonio Ilardi, Umberto Manera, Cristina Moglia, Kalliopi Marinou, Edo Bottacchi, Fabrizio Pisano, Gabriele Mora, Letizia Mazzini, Adriano Chiò

Research output: Contribution to journalArticlepeer-review


Objective To assess the prognostic influence of premorbid smoking habits and vascular risk profile on amyotrophic lateral sclerosis (ALS) phenotype and outcome in a population-based cohort of Italian patients. Methods A total of 650 patients with ALS from the Piemonte/Valle d'Aosta Register for ALS, incident in the 2007-2011 period, were recruited. Information about premorbid cigarette smoking habits and chronic obstructive pulmonary disease (COPD) were collected at the time of diagnosis. Results Current smokers had a significantly shorter median survival (1.9â €..years, IQR 1.2-3.4) compared with former (2.3â €..years, IQR 1.5-4.2) and never smokers (2.7â €..years, IQR 1.8-4.6) (p=0.001). Also COPD adversely influenced patients' prognosis. Both smoking habits and CODP were retained in Cox multivariable model. Conclusions This study has demonstrated in a large population-based cohort of patients with ALS that cigarette smoking is an independent negative prognostic factor for survival, with a dose-response gradient. Its effect is not related to the presence of COPD or to respiratory status at time of diagnosis. The understanding of the mechanisms, either genetic or epigenetic, through which exogenous factors influence disease phenotype is of major importance towards a more focused approach to cure ALS.

Original languageEnglish
Pages (from-to)1229-1233
Number of pages5
JournalJournal of Neurology, Neurosurgery and Psychiatry
Issue number11
Publication statusPublished - Nov 1 2016

ASJC Scopus subject areas

  • Surgery
  • Arts and Humanities (miscellaneous)
  • Clinical Neurology
  • Psychiatry and Mental health


Dive into the research topics of 'Influence of cigarette smoking on ALS outcome: A population-based study'. Together they form a unique fingerprint.

Cite this