TOBACCO AND NEURODEGENERATIVE DISEASES MiniLecture 3 Module Tobacco

TOBACCO AND NEURODEGENERATIVE DISEASES Mini-Lecture 3 Module : Tobacco and the Nervous System

Objectives of the Mini Lecture Goals of Mini Lecture: Provide students with knowledge about the effect of smoking on risk of developing neurodegenerative diseases. Learning Objectives of Mini Lecture: Students will be able to: • Describe the effect of smoking on the risk of developing multiple sclerosis and its progression. • Describe the effect of smoking on Alzheimer’s disease. • Describe the effect of smoking on Parkinson’s disease. • Explain why smoking cessation is important.

Contents Core Slides: 1. Smoking and Multiple Sclerosis Risk 2. Smoking and MS Progression 3. Secondhand Smoke and MS 4. Smoking and Alzheimer’s Disease 5. Smoking and Parkinson’s Disease 6. Discussion: Smoking vs. Quitting Optional Slides: 1. Smoking and MS: Mechanisms (1– 2)

CORE SLIDES Tobacco and Neurodegenerative Disease Mini Lecture 3 Module: Tobacco and The Nervous System

Smoking and Multiple Sclerosis Risk • Increased risk of developing multiple sclerosis (MS)1, 2 • Increased risk among active smokers 2 • Incidence of MS increased with cumulative exposure to smoking 2 http: //www. elements 4 health. com/images/stories/conditions/multiple-sclerosis. jpg 1. Hawkes 2007; 2. Mikaeloff 2007

Smoking and MS Progression • Relapsing-remitting MS patients continuing to smoke: increased risk of entering secondary progressive phase of disease 1 • Increased risk of severe disease 2 http: //www. knowledgebase-script. com/demo/admin/attachments/multiple-sclerosis. jpg 1. Hawkes 2007; 2. Mikaeloff 2007

Secondhand Smoke and MS • Parental smoking at home: increased risk of first episode of MS in children (2. 12 times). 1 • Significantly associated with prolonged duration of exposure in older cases. http: //www. elements 4 health. com/images/stories/conditions/myelin-sheath. jpg 1. Mikaeloff 2007

Smoking and Alzheimer’s Disease • Most studies show inverse association between smoking and Alzheimer's disease (AD), i. e. protective. 1 • However, Rotterdam study shows twice the risk of AD among smokers. 2 • Protective association restricted to patients with family history of dementia. 1 1. van Duijn et al. 1991; 2. Merchant et al. 1999

Smoking and Parkinson’s Disease 1 • Patients with Parkinson's disease (PD) observed to smoke less than control subjects • Most studies of cigarette smoking and PD have reported a protective effect of smoking http: //www. about-dementia. com/images/Parkinsons. Dopamine. jpg 1. van Duijn et al. 1991

Discussion: Smoking vs. Quitting • Data on protective effect of smoking on AD and PD is inconclusive. • Moreover, smoking is a known risk factor for many major diseases like stroke, heart disease, etc. • No overall advantage in smoking.

OPTIONAL SLIDES Tobacco and Neurodegenerative Disease Mini Lecture 3 Module: Tobacco and The Nervous System

Smoking and MS: Mechanisms (1) • Immune stimulation or suppression 1 • Direct effect of cigarette smoke components 1, 2: increased blood-brain permeability • Induces deficiency of interferon gamma producing cells in adenoids of children 2 http: //2 getherwewill. com/yahoo_site_admin/assets/images/mscleros. 32502053_std. gif 1. Hawkes 2007; 2. Mikaeloff et al. 2007

Smoking and MS: Mechanisms (2) Direct toxic effects on the central nervous system 1: • Demyelination by cyanide (cigarette smoke)1 • Axonal degeneration due to nitric oxide 2 http: //repairstemcell. files. wordpress. com/2009/02/ww 5 r 308_big. jpg 1. Mikaeloff et al. 2007; 2. Hawkes 2007

The most important health message a doctor can give to patients is to quit smoking.