Biology subjects

Munafo, M.

Publications and source records attributed to Munafo, M..

3 recordsLinked to original sources

bioRxiv2018

The effect of education and general cognitive ability on smoking: A Mendelian randomisation study

Recent analyses have shown educational attainment to be associated with a number of health outcomes. This association may, in part, be due to an effect of educational attainment on smoking behaviour. In this study we apply a multivariable Mendelian randomisation design to determine whether the effect of educational attainment on smoking behaviour could be due to educational attainment or general cognitive ability. We use individual data from the UK Biobank study (N = 120,050) and summary data from large GWAS studies of educational attainment, cognitive ability and smoking behaviour. Our results show that more years of education are associated with a reduced likelihood of smoking which is not due to an effect of general cognitive ability on smoking behaviour. Given the considerable physical harms associated with smoking, the effect of educational attainment on smoking is likely to contribute to the health inequalities associated with differences in educational attainment.

epidemiology↗

bioRxiv2018

The effect of body mass index on smoking behaviour and nicotine metabolism: a Mendelian randomization study

BackgroundGiven clear evidence that smoking lowers weight, it is possible that individuals with higher body mass index (BMI) smoke in order to lose or maintain their weight.\n\nMethods and FindingsWe undertook Mendelian randomization analyses using 97 genetic variants associated with BMI. We performed two sample Mendelian randomization analyses of the effects of BMI on smoking behaviour in UK Biobank (N=335,921) and the Tobacco and Genetics consortium genomewide association study (GWAS) (N[≤]74,035) respectively, and two sample Mendelian randomization analyses of the effects of BMI on cotinine levels (N[≤]4,548) and nicotine metabolite ratio (N[≤]1,518) in published GWAS, and smoking-related DNA methylation in the Avon Longitudinal Study of Parents and Children (N[≤]846).\n\nIn inverse variance weighted Mendelian randomization analysis, there was evidence that higher BMI was causally associated with smoking initiation (OR for ever vs never smoking per one SD increase in BMI: 1.19, 95% CI: 1.11 to 1.27) and smoking heaviness (1.45 additional cigarettes smoked per day per SD increase in BMI, 95% CI: 1.03 to 1.86), but little evidence for a causal effect with smoking cessation. Results were broadly similar using pleiotropy robust methods (MR-Egger, median and weighted mode regression). These results were supported by evidence for a causal effect of BMI on DNA methylation at the aryl-hydrocarbon receptor repressor (AHRR) locus. There was no strong evidence that BMI was causally associated with cotinine, but suggestive evidence for a causal negative association with the nicotine metabolite ratio.\n\nConclusionsThere is a causal bidirectional association between BMI and smoking, but the relationship is likely to be complex due to opposing effects on behaviour and metabolism. It may be useful to consider BMI and smoking together when designing prevention strategies to minimise the effects of these risk factors on health outcomes.

epidemiology↗

bioRxiv2017

Evaluating Clinical Stop-Smoking Services Globally: Proposal For A Minimum Data Set

Background and aimsBehavioural and pharmacological support for smoking cessation improves the chances of success and represents a highly cost-effective way of preventing chronic disease and premature death. There are a large number of clinical stop-smoking services around the world. These could be connected into a global network to provide data to assess what treatment components are most effective, for what populations, in what settings. This requires data to be collected according to a minimum standard set of data items. This paper sets out a proposal for this global minimum data set.\n\nMethodsWe reviewed sets of data items used in clinical services that have already benefited from standardised approaches to using data. We identified client and treatment data items that may directly or indirectly influence outcome, and outcome variables that were practicable to obtain in clinical practice. We then consulted service providers in countries that may have an interest in taking part in a global network of smoking cessation services, and revised the sets of data items according to their feedback.\n\nResultsThree sets of data items are proposed. The first is a set of features characterising treatments offered by a service. The second is a core set of data items describing clients characteristics, engagement with the service, and outcomes. The third is an extended set of client data items to be captured in addition to the core data items wherever resources permit.\n\nConclusionsWe propose minimum standards for capturing data from clinical smoking cessation services globally. This could provide a basis for meaningful evaluations of different smoking cessation treatments in different populations in a variety of settings across many countries.

epidemiology↗