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ARTICLE |

Coffee, Tobacco, and Cardiovascular Disease: The Self-Selection Problem

Richard J. Hickey, PhD; Richard C. Clelland, PhD; David E. Boyce, PhD; Evelyn J. Bowers
JAMA. 1974;228(2):160. doi:10.1001/jama.1974.03230270020016.
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To the Editor.—  Disparate findings have been reported regarding the question of possible harm to health resulting from coffee drinking.1-6 The association of coffee and tobacco use1-4 was suggested as a confounding factor.1In a prospective study, Thomas7 showed significant positive association between coffee drinking and cigarette smoking. A similar finding was also reported by Hrubec.8 Palotas,5 using international data, reported significant positive correlation between "apparent per capita coffee consumption and deaths per 100,000 from arteriosclerotic and degenerative heart disease" for 16 countries. For six European countries, grossly similar in diet and climate, a highly significant positive correlation was found. Since significant associations evidently exist between coffee drinking and cigarette smoking on the one hand, and between coffee drinking and risk of certain cardiovascular diseases9,10 on the other, the suggestion1 that the "discrepancies" might be related to cigarette smoking needs clarification.Usage

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