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Psychol Med. 2008 Sep;38(9):1287-97. Epub 2007 Oct 22.

Educational attainment, smoking initiation and lifetime nicotine dependence among male Vietnam-era twins.

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  • 1Centers for Behavioral and Preventive Medicine, Brown Medical School and The Miriam Hospital, Providence, RI 02903, USA. Jeanne_McCaffery@brown.edu



Smoking initiation and persistence are clearly associated with factors commonly thought to be environmental in origin, including socio-economic status. However, twin models that incorporate gene-environment correlation and gene x environment interaction have not been applied to elucidate the genetic or environmental role that socio-economic status plays in smoking initiation and nicotine dependence.


Twin structural equation modelling was used to examine gene-environment correlation and gene x environment interaction of one index of socio-economic status, educational attainment, with smoking initiation and nicotine dependence among 5119 monozygotic and 4295 dizygotic male-male Vietnam-era twins from the Vietnam Era Twin Registry, a national registry of twin pairs who served in the military during the Vietnam era.


Educational attainment correlated significantly with smoking initiation (r=-0.27, p<0.001). Additive genetic (p=0.011), shared environment (p=0.002) and unique environment (p=0.027) components contributed to the correlation between educational attainment and smoking initiation. Educational attainment also significantly moderated the variance in smoking initiation (p<0.001), suggestive of gene x environment interaction, although the interaction with the additive genetic, shared environmental and unique environmental components could not be resolved due to multi-collinearity. In contrast, educational attainment neither correlated with nor moderated nicotine dependence, once smokers had initiated.


Our study suggests that educational attainment is associated with smoking initiation, in part due to gene-environment correlation and gene x environment interaction. However, once smoking initiation is taken into account, there are no effects--be they gene-environment correlation or gene x environmental interaction--of educational attainment on nicotine dependence.

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