ArticlePsychological medicine2022
Does smoking cause lower educational attainment and general cognitive ability? Triangulation of causal evidence using multiple study designs.
Article in Psychological medicine, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 2 of them syntheses that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
11 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Maternal Cigarette Smoking and Cleft Lip and Palate: A Systematic Review and Meta-Analysis.The Cleft palate-craniofacial journal : official publication of the American Cleft Palate-Craniofacial Association · 2022Pooled it
- Using Mendelian randomization analysis to better understand the relationship between mental health and substance use: a systematic review.Psychological medicine · 2021Pooled it
- Exploring the genetic overlap between substance use disorder and educational attainment.Addiction (Abingdon, England) · 2026Article
- Avon Longitudinal Study of Parents and Children (ALSPAC) summary education attainment values in the offspring generation.Wellcome open research · 2026Article
- Reassessing the link between adiposity and head and neck cancer: a Mendelian randomization study.eLife · 2025Article
- The causal association between cardiovascular proteins and diabetic nephropathy: a Mendelian randomization study.International urology and nephrology · 2025Article
- Strengthening Rigor and Reproducibility in Epigenome-Wide Association Studies of Social Exposures and Brain-Based Health Outcomes.Current environmental health reports · 2025Review
- Associations between health behaviours, fertility and reproductive outcomes: triangulation of evidence in the Norwegian Mother, Father and Child Cohort Study (MoBa).BMC medicine · 2023Article
- Interpreting Mendelian-randomization estimates of the effects of categorical exposures such as disease status and educational attainment.International journal of epidemiology · 2022Article
- Genetic Risk for Smoking: Disentangling Interplay Between Genes and Socioeconomic Status.Behavior genetics · 2022Article
- Causal inference with observational data: the need for triangulation of evidence.Psychological medicine · 2021Article
Corrections and comments
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Authors and funding
7 authors.
Funding
Abstract
backgroundObservational studies have found associations between smoking and both poorer cognitive ability and lower educational attainment; however, evaluating causality is challenging. We used two complementary methods to explore this.
methodsWe conducted observational analyses of up to 12 004 participants in a cohort study (Study One) and Mendelian randomisation (MR) analyses using summary and cohort data (Study Two). Outcome measures were cognitive ability at age 15 and educational attainment at age 16 (Study One), and educational attainment and fluid intelligence (Study Two).
resultsStudy One: heaviness of smoking at age 15 was associated with lower cognitive ability at age 15 and lower educational attainment at age 16. Adjustment for potential confounders partially attenuated findings (e.g. fully adjusted cognitive ability
conclusionWe find some evidence of a causal effect of smoking on lower educational attainment, but not cognitive ability. Triangulation of evidence across observational and MR methods is a strength, but the genetic variants associated with smoking initiation may be pleiotropic, suggesting caution in interpreting these results. The nature of this pleiotropy warrants further study.
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