SAMMENDRAGDen negative sammenhengen mellom r?yking og Parkinsons sykdom i epidemiologiske studier er robust.Det er prosentvis f?rre r?ykere og eks-r?ykere blant Parkinson-pasienter enn blant kontrollpersoner.Videre har r?ykere en lavere insidens og en lavere d?delighet enn andre av Parkinsons sykdom. Det er et?pent sp?rsm?l om dette skyldes en beskyttende virkning av nikotin eller andre stoffer i tobakksr?yk somhydrazin eller karbonmonoksid, eller om det skyldes andre, underliggende faktorer. De mest aktuelle slikefaktorer er (1) selektiv d?delighet, alts? at mange r?ykere ikke overlever lenge nok til ? utvikleParkinsons sykdom, og (2) at personer som utvikler Parkinsons sykdom ofte har karaktertrekk som gj?rdet mindre sannsynlig at de begynner ? r?yke. Det vitenskapelige grunnlaget er i alle fall for tynt for ?anbefale r?yking som et forebyggende virkemiddel mot Parkinsons sykdom. Og selv om det skulle viseseg at r?yking virkelig beskytter mot sykdommen, veier de negative helsevirkningene av r?yking myetyngre i folkehelsesammenheng. Allikevel b?r denne assosiasjonen forf?lges videre, ikke minst forpotensialet for en bedret forst?else av de underliggende patofysiologiske mekanismene bak sykdommen.Flaten TP.?Does smoking protect against Parkinson’s disease? Nor J Epidemiol 1995; 5 (2): 145-150.?ENGLISH SUMMARYIt is epidemiologically well established that Parkinson's disease is about twice as common among nonsmokers as among smokers. Whether this is due to a protective effect of nicotine or other compounds in cigarette smoke like hydrazine or carbon monoxide, or whether it is due to some other, confounding factor(s), remains to be established. The most relevant confounding factors are (1) selective mortality, that is, many smokers do not survive long enough to develop Parkinson's disease, and (2) that persons who eventually develop Parkinson's disease tend to have a preclinical personality type that makes them less likely to pick up the smoking habit. In any case, the scientific basis is not strong enough to recommend smoking as a preventive strategy in Parkinson's disease. And even if it were clearly demonstrated that smoking protects against the disease, the known adverse effects of smoking are so serious that any beneficial effects on Parkinson's disease could not possibly compensate for this hazard. However, unraveling the mechanism behind the reduced risk of Parkinson's disease in smokers may provide clues to an improved understanding of the pathophysiological mechanisms behind the disease.
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