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BMJ Open. 2014 Oct 7;4(10):e006141. doi: 10.1136/bmjopen-2014-006141.

Investigating the possible causal association of smoking with depression and anxiety using Mendelian randomisation meta-analysis: the CARTA consortium.

Author information

1
MRC Integrative Epidemiology Unit (IEU) at the University of Bristol, UK.
2
UK Centre for Tobacco and Alcohol Studies, School of Experimental Psychology, University of Bristol, Bristol, UK.
3
Department of Public Health, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway.
4
Forensic Department, Research Centre Bröset St. Olav's University Hospital Trondheim, Trondheim, Norway.
5
Faculty of Medicine, Department of Laboratory Medicine, Children's and Women's Health, Norwegian University of Science and Technology, Trondheim, Norway.
6
Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, Edinburgh, UK.
7
Medical Genetics Section, Centre for Genomic and Experimental Medicine, Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh, UK.
8
Queensland Brain Institute, The University of Queensland, Brisbane, QLD, Australia.
9
Department of Epidemiology and Public Health, University College London, London, UK.
10
Department of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands.
11
University of Helsinki, Hjelt institute, Helsinki, Finland.
12
University of Eastern Finland, Institute of Public Health & Clinical Nutrition, Kuopio, Finland.
13
Department of Chronic Disease Prevention, National Institute for Health and Welfare, Helsinki, Finland.
14
Hospital District of North Karelia, Joensuu, Finland.
15
Department of Mental Health and Substance Abuse Services, National Institute for Health and Welfare, Helsinki, Finland.
16
Institute of Health Sciences, FI-90014 University of Oulu, Finland.
17
Biocenter Oulu, FI-90014 University of Oulu, Finland.
18
South West London and St George's Mental Health Trust, London, UK.
19
Population, Policy and Practice, UCL Institute of Child Health, University College London, UK.
20
Research Centre for Prevention and Health, the Capital Region of Denmark, Denmark.
21
Metabolic Genetics Section, Faculty of Health and Medical Sciences, Novo Nordisk Foundation Centre for Basic Metabolic Research, University of Copenhagen, Copenhagen, Denmark.
22
Copenhagen Prospective Studies on Asthma in Childhood, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
23
Danish Pediatric Asthma Center, Gentofte Hospital, The Capital Region, Copenhagen, Denmark.
24
Institute of Public Health and Center for Healthy Aging, University of Copenhagen, Denmark.
25
Department of Biological Psychology, Netherlands Twin Register, VU University, Amsterdam, The Netherlands.
26
Department of Internal Medicine, Lausanne University Hospital, Lausanne, Switzerland.
27
Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK.
28
Department of Primary Care & Population Health, UCL, London, UK.
29
Institute of Behavioural Sciences, University of Helsinki, Helsinki, Finland.
30
Folkhälsan Research Centre, Helsinki, Finland.
31
Wellcome Trust Sanger Institute, Cambridge, UK.
32
The Medical and Population Genomics Program, The Broad Institute of MIT and Harvard, Cambridge, Massachusetts, USA.
33
Institute for Molecular Medicine Finland (FIMM), University of Helsinki, Finland.
34
MRC Unit for Lifelong Health, Ageing at UCL, UK.
35
School of Social and Community Medicine, University of Bristol, Bristol, UK.
36
Department of Psychology, University of Toronto, Toronto, Canada.
37
Rotman Research Institute, Toronto, Canada.
38
Department of Psychological Medicine, University of Otago, Christchurch, New Zealand.
39
Childhood Cancer Research Group, University of Oxford, Oxford, UK.
40
Department of Oncology, University of Oxford, Oxford, UK.
41
Department of Pathology, University of Otago, Christchurch, New Zealand.
42
Departments of Physiology and Nutritional Sciences, University of Toronto, Toronto, Canada.
43
Hospital for Sick Children, Toronto, Canada.
44
Departments of Psychology and Psychiatry, University of Toronto, Toronto, Canada.
45
Institute for Clinical Research, University of Southern Denmark, Odense, Denmark.
46
Department of Medical Genetics, University of Helsinki and University Central Hospital, Helsinki, Finland.
47
National Institute for Health and Welfare, Finland.
48
Department of General Practice and Primary health Care, University of Helsinki, Finland.
49
Unit of General Practice, Helsinki University Central Hospital, Helsinki, Finland.
50
Vasa Central Hospital, Vasa, Finland.
51
Institute of Cardiovascular Science, University College London, UK.
52
Department of Psychiatry, Lausanne University Hospital, Prilly, Switzerland.
53
Department of Clinical Experimental Research, Glostrup University Hospital, Denmark.
54
Faculty of Health and Medical Sciences, Department of Clinical Medicine, University of Copenhagen, Denmark.
55
School of Population Health and Sansom Institute, University of South Australia, Adelaide, Australia.
56
South Australian Health and Medical Research Institute, Adelaide, Australia.
57
Department of Psychiatry, Oulu University Hospital, Oulu, Finland.
58
Department of Epidemiology and Biostatistics, MRC Health Protection Agency (HPA) Centre for Environment and Health, School of Public Health, Imperial College London, UK.
59
Unit of Primary Care, Oulu University Hospital, Oulu, Finland.
60
Department of Children and Young People and Families, National Institute for Health and Welfare, Oulu, Finland.
61
Department of Epidemiology and Psychiatry, Erasmus Medical Center, Rotterdam, The Netherlands.
62
Medical Research Council Human Genetics Unit, Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh, UK.

Abstract

OBJECTIVES:

To investigate whether associations of smoking with depression and anxiety are likely to be causal, using a Mendelian randomisation approach.

DESIGN:

Mendelian randomisation meta-analyses using a genetic variant (rs16969968/rs1051730) as a proxy for smoking heaviness, and observational meta-analyses of the associations of smoking status and smoking heaviness with depression, anxiety and psychological distress.

PARTICIPANTS:

Current, former and never smokers of European ancestry aged ≥16 years from 25 studies in the Consortium for Causal Analysis Research in Tobacco and Alcohol (CARTA).

PRIMARY OUTCOME MEASURES:

Binary definitions of depression, anxiety and psychological distress assessed by clinical interview, symptom scales or self-reported recall of clinician diagnosis.

RESULTS:

The analytic sample included up to 58 176 never smokers, 37 428 former smokers and 32 028 current smokers (total N=127 632). In observational analyses, current smokers had 1.85 times greater odds of depression (95% CI 1.65 to 2.07), 1.71 times greater odds of anxiety (95% CI 1.54 to 1.90) and 1.69 times greater odds of psychological distress (95% CI 1.56 to 1.83) than never smokers. Former smokers also had greater odds of depression, anxiety and psychological distress than never smokers. There was evidence for positive associations of smoking heaviness with depression, anxiety and psychological distress (ORs per cigarette per day: 1.03 (95% CI 1.02 to 1.04), 1.03 (95% CI 1.02 to 1.04) and 1.02 (95% CI 1.02 to 1.03) respectively). In Mendelian randomisation analyses, there was no strong evidence that the minor allele of rs16969968/rs1051730 was associated with depression (OR=1.00, 95% CI 0.95 to 1.05), anxiety (OR=1.02, 95% CI 0.97 to 1.07) or psychological distress (OR=1.02, 95% CI 0.98 to 1.06) in current smokers. Results were similar for former smokers.

CONCLUSIONS:

Findings from Mendelian randomisation analyses do not support a causal role of smoking heaviness in the development of depression and anxiety.

KEYWORDS:

Anxiety; Depression; Mendelian randomisation; Smoking

PMID:
25293386
PMCID:
PMC4187451
DOI:
10.1136/bmjopen-2014-006141
[Indexed for MEDLINE]
Free PMC Article

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