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Behavioural Neurology
Volume 15 (2004), Issue 3-4, Pages 65-71

Parkinson’s Disease Protects Against Smoking?

Mohamed Farouk Allam,1 Michael J. Campbell,2 Amparo Serrano Del Castillo,1 and Rafael Fernández-Crehuet Navajas1

1Department of Preventive Medicine and Public Health, Faculty of Medicine, University of Cordoba, Cordoba, Spain
2Institute of General Practice & Primary Care, University of Sheffield, Sheffield S5 7AU, UK

Received 24 January 2005; Accepted 24 January 2005

Copyright © 2004 Hindawi Publishing Corporation and the authors. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Our aim was to estimate the pooled risk of current and former smoking for Parkinson’s disease (PD).We have reviewed all observational studies that evaluated the association between PD risk and smoking habit. Twenty six studies were identified: 21 case-control, 4 cohort and 1 cross-sectional. The cross-sectional study did not compare former with never smokers. These studies were carried out between 1968 and 2000.

There was an obvious protective effect of current smoking in the pooled estimate [risk estimate 0.37 (95% confidence interval 0.33 to 0.41)]. Former versus never smokers had pooled risk estimate of 0.84 (95% confidence interval 0.76 to 0.92). Current and former smoking do not, therefore, exert the same protective effect against PD so that it is unnecessary to postulate a biological mechanism through which smoking protects against PD. The results show that the reverse direction of causation is a more probable explanation, i.e. movement disorders of PD protect against smoking. Another explanation is that failure to develop strong smoking habits in early adult life might be a prodromal symptom of the disease and could perhaps be its first clinical manifestation.