Tobacco, coffee, and Parkinson's disease

doi:10.1136/bmj.326.7389.561

BMJ 2003;326:561-562 ( 15 March )

Editorials

Tobacco, coffee, and Parkinson's disease

Caffeine and nicotine may improve the health of dopaminergic systems

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Parkinson's disease belongs to that small group of conditions that occur less often among cigarette smokers than in non-smokers.The observation was first made in a case-control study over 30years ago,¹ but, as Hernán and colleagues have shown in theirrecent systematic review and meta-analysis,² the finding hasbeen replicated many times. The protective effect is large $---$ accordingto the pooled data, current smokers have a 60% reduction in riskcompared with those who have never smoked $---$ and consistent betweenstudies in different settings. The fact that two very large prospectivestudies found a similar reduction in risk to that seen in retrospectivestudies rules out the possibility that the association can beaccounted for by differential survival between smokers and non-smokers.³Coffee drinking too, seems to protect against Parkinson's disease.Here the pooled estimate is a 30% reduction in risk for coffeedrinkers compared with non-drinkers.

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