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Tobacco, coffee, and Parkinson's disease

BMJ 2003; 326 doi: (Published 15 March 2003) Cite this as: BMJ 2003;326:561

This article has a correction. Please see:

Caffeine and nicotine may improve the health of dopaminergic systems

  1. Christopher Martyn, clinical scientist (,
  2. Chris Gale, senior research fellow
  1. MRC Environmental Epidemiology Unit, Southampton General Hospital, Southampton SO16 6YD

    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 30 years ago,1 but, as Hernán and colleagues have shown in their recent systematic review and meta-analysis,2 the finding has been replicated many times. The protective effect is large—according to the pooled data, current smokers have a 60% reduction in risk compared with those who have never smoked—and consistent between studies in different settings. The fact that two very large prospective studies found a similar reduction in risk to that seen in retrospective studies rules out the possibility that the association can be accounted for by differential survival between smokers and non-smokers.3 Coffee drinking too, seems to protect against Parkinson's disease. Here the pooled estimate is a 30% reduction in risk for coffee drinkers compared with non-drinkers.

    In “An Essay on the Shaking Palsy,” …

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