SynthesisBMJ open2014
Investigating the possible causal association of smoking with depression and anxiety using Mendelian randomisation meta-analysis: the CARTA consortium.
Abstract readMeta-AnalysisObservational Study
In one paragraph
Synthesis in BMJ open, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 76 papers, 9 of them syntheses that pooled it.
0numbers the graph read from it
0cells of the map it votes in
76citing papers in PubMed, 9 pooled it
–field-weighted citation impact
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
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.
The trial behind it
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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
76 citing papers in PubMed, 9 syntheses or guidelines pooled it.
- TFOS lifestyle: Impact of societal challenges on the ocular surface.The ocular surface · 2023Pooled it
- Longitudinal association between cardiovascular risk factors and depression in young people: a systematic review and meta-analysis of cohort studies.Psychological medicine · 2023Pooled it
- The Promise of Polygenic Risk Prediction in Smoking Cessation: Evidence From Two Treatment Trials.Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco · 2022Pooled it
- Using Mendelian randomization analysis to better understand the relationship between mental health and substance use: a systematic review.Psychological medicine · 2021Pooled it
- Psychiatric research in the Northern Finland Birth Cohort 1986 - a systematic review.International journal of circumpolar health · 2019Pooled it
- Assessment of the genetic and clinical determinants of fracture risk: genome wide association and mendelian randomisation study.BMJ (Clinical research ed.) · 2018Pooled it
- The Association of Cigarette Smoking With Depression and Anxiety: A Systematic Review.Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco · 2017Pooled it
- Effect of smoking on physical and cognitive capability in later life: a multicohort study using observational and genetic approaches.BMJ open · 2015Pooled it
- Effect of Smoking on Blood Pressure and Resting Heart Rate: A Mendelian Randomization Meta-Analysis in the CARTA Consortium.Circulation. Cardiovascular genetics · 2015Pooled it
- Change in cardiovascular health among adults with current or past major depressive disorder enrolled in intensive smoking cessation treatment.Journal of affective disorders · 2023Trial
- Parental Depression is Prospectively Associated With Lower Smoking Cessation Rates and Poor Child Asthma Outcomes.Annals of behavioral medicine : a publication of the Society of Behavioral Medicine · 2018Trial
- Mental health profiles and resilience among medical students in an active conflict zone: a cluster analysis.Medical education online · 2026Article
- Nicotine metabolite ratio and clinically significant depressive symptoms in U.S. adults: A smoker-specific association.Medicine · 2026Observational
- Risk of anxiety disorder following ankylosing spondylitis, 2012-2023: a nationwide cohort study in South Korea.Frontiers in psychiatry · 2026Article
- Associations of cerebrospinal fluid metal ion profiles with depressive symptoms in active smokers: a cross-sectional network analysis.Frontiers in psychiatry · 2026Article
- Psychological outcomes of smoking cessation supported by telemedicine in real-world clinical practice: A prospective longitudinal cohort study.Tobacco induced diseases · 2026Article
- From cigarettes to symptoms: the association between smoking and depression in the German National Cohort (NAKO).BMC public health · 2025Article
- Cumulative associations between health behaviours, mental well-being, and health over 30 years.Annals of medicine · 2025Article
- The influence of CHRNA5 and D398N missense variation on social and emotional behaviors in rodents and humans.Translational psychiatry · 2025Article
- METS-IR and SII as mediators in the association between smoking and depressive symptoms: insights from NHANES (2005-2018).BMC psychiatry · 2025Article
16 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
62 authors.
Amy E TaylorMRC Integrative Epidemiology Unit (IEU) at the University of Bristol, UK.
Meg E FluhartyMRC Integrative Epidemiology Unit (IEU) at the University of Bristol, UK.
Johan H BjørngaardDepartment of Public Health, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway.
Maiken Elvestad GabrielsenFaculty of Medicine, Department of Laboratory Medicine, Children's and Women's Health, Norwegian University of Science and Technology, Trondheim, Norway.
Frank SkorpenFaculty of Medicine, Department of Laboratory Medicine, Children's and Women's Health, Norwegian University of Science and Technology, Trondheim, Norway.
Riccardo E MarioniCentre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, Edinburgh, UK.
Archie CampbellMedical Genetics Section, Centre for Genomic and Experimental Medicine, Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh, UK.
Jorgen EngmannDepartment of Epidemiology and Public Health, University College London, London, UK.
Saira Saeed MirzaDepartment of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands.
Anu LoukolaUniversity of Helsinki, Hjelt institute, Helsinki, Finland.
Tiina LaatikainenUniversity of Eastern Finland, Institute of Public Health & Clinical Nutrition, Kuopio, Finland.
Timo PartonenDepartment of Mental Health and Substance Abuse Services, National Institute for Health and Welfare, Helsinki, Finland.
Marika KaakinenInstitute of Health Sciences, FI-90014 University of Oulu, Finland.
Francesca DucciSouth West London and St George's Mental Health Trust, London, UK.
Alana CavadinoPopulation, Policy and Practice, UCL Institute of Child Health, University College London, UK.
Lise Lotte N HusemoenResearch Centre for Prevention and Health, the Capital Region of Denmark, Denmark.
Tarunveer Singh AhluwaliaMetabolic Genetics Section, Faculty of Health and Medical Sciences, Novo Nordisk Foundation Centre for Basic Metabolic Research, University of Copenhagen, Copenhagen, Denmark.
Rikke Kart JacobsenResearch Centre for Prevention and Health, the Capital Region of Denmark, Denmark.
Tea SkaabyResearch Centre for Prevention and Health, the Capital Region of Denmark, Denmark.
Jeanette Frost EbstrupResearch Centre for Prevention and Health, the Capital Region of Denmark, Denmark.
Erik Lykke MortensenInstitute of Public Health and Center for Healthy Aging, University of Copenhagen, Denmark.
Camelia C MinicaDepartment of Biological Psychology, Netherlands Twin Register, VU University, Amsterdam, The Netherlands.
Jacqueline M VinkDepartment of Biological Psychology, Netherlands Twin Register, VU University, Amsterdam, The Netherlands.
Gonneke WillemsenDepartment of Biological Psychology, Netherlands Twin Register, VU University, Amsterdam, The Netherlands.
Pedro Marques-VidalDepartment of Internal Medicine, Lausanne University Hospital, Lausanne, Switzerland.
Caroline E DaleFaculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK.
Antoinette AmuzuFaculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK.
Lucy T LennonDepartment of Primary Care & Population Health, UCL, London, UK.
Jari LahtiInstitute of Behavioural Sciences, University of Helsinki, Helsinki, Finland.
Aarno PalotieWellcome Trust Sanger Institute, Cambridge, UK.
Katri RäikkönenFolkhälsan Research Centre, Helsinki, Finland.
Andrew WongMRC Unit for Lifelong Health, Ageing at UCL, UK.
Lavinia PaternosterMRC Integrative Epidemiology Unit (IEU) at the University of Bristol, UK.
Angelita Pui-Yee WongDepartment of Psychology, University of Toronto, Toronto, Canada.
L John HorwoodDepartment of Psychological Medicine, University of Otago, Christchurch, New Zealand.
Michael MurphyChildhood Cancer Research Group, University of Oxford, Oxford, UK.
Elaine C JohnstoneDepartment of Oncology, University of Oxford, Oxford, UK.
Martin A KennedyDepartment of Pathology, University of Otago, Christchurch, New Zealand.
Zdenka PausovaDepartments of Physiology and Nutritional Sciences, University of Toronto, Toronto, Canada.
Tomáš PausRotman Research Institute, Toronto, Canada.
Yoav Ben-ShlomoSchool of Social and Community Medicine, University of Bristol, Bristol, UK.
Ellen A NohrInstitute for Clinical Research, University of Southern Denmark, Odense, Denmark.
Diana KuhMRC Unit for Lifelong Health, Ageing at UCL, UK.
Mika KivimakiDepartment of Epidemiology and Public Health, University College London, London, UK.
Johan G ErikssonFolkhälsan Research Centre, Helsinki, Finland.
Richard W MorrisDepartment of Primary Care & Population Health, UCL, London, UK.
Juan P CasasFaculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK.
Martin PreisigDepartment of Psychiatry, Lausanne University Hospital, Prilly, Switzerland.
Dorret I BoomsmaDepartment of Biological Psychology, Netherlands Twin Register, VU University, Amsterdam, The Netherlands.
Allan LinnebergResearch Centre for Prevention and Health, the Capital Region of Denmark, Denmark.
Chris PowerPopulation, Policy and Practice, UCL Institute of Child Health, University College London, UK.
Elina HyppönenPopulation, Policy and Practice, UCL Institute of Child Health, University College London, UK.
Juha VeijolaDepartment of Psychiatry, Oulu University Hospital, Oulu, Finland.
Marjo-Riitta JarvelinInstitute of Health Sciences, FI-90014 University of Oulu, Finland.
Tellervo KorhonenUniversity of Helsinki, Hjelt institute, Helsinki, Finland.
Henning TiemeierDepartment of Epidemiology and Psychiatry, Erasmus Medical Center, Rotterdam, The Netherlands.
Meena KumariDepartment of Epidemiology and Public Health, University College London, London, UK.
David J PorteousCentre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, Edinburgh, UK.
Caroline HaywardMedical Research Council Human Genetics Unit, Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh, UK.
Pål R RomundstadDepartment of Public Health, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway.
George Davey SmithMRC Integrative Epidemiology Unit (IEU) at the University of Bristol, UK.
Marcus R MunafòMRC Integrative Epidemiology Unit (IEU) at the University of Bristol, UK.
Funding
Type 1 Diabetes Genetics ConsortiumU01DK062418 · NIDDK · WAKE FOREST UNIVERSITY HEALTH SCIENCES · PI RICH, STEPHEN S. · 2002 to 2007
$59.8MProject-001R01AG017644 · NIA · UNIVERSITY OF LONDON INST OF NEUROLOGY · PI Andrew Steptoe · 2000 to 2026
$56.2MLCenter for Clinical and Translational Science and TrainingUL1TR001425 · NCATS · UNIVERSITY OF CINCINNATI · PI HEUBI, JAMES E., KISSELA, BRETT M · 2015 to 2024
$37.5MCHANGES IN HEALTH: SOCIO-ECONOMIC STATUS AND PATHWAYSR37AG013196 · NIA · UNIVERSITY OF LONDON INST OF NEUROLOGY · PI MARMOT, MICHAEL G · 1999 to 2008
$4.3MGenetics of cardiovascular risk factors in large founder population birth controlR01HL087679 · NHLBI · MASSACHUSETTS INSTITUTE OF TECHNOLOGY · PI HIRSCHHORN, JOEL N · 2007 to 2009
$4.0MSocio-economic status and heterogeneity in agingR01AG013196 · NIA · UNIVERSITY OF LONDON INST OF NEUROLOGY · PI MARMOT, MICHAEL G, SINGH-MANOUX, ARCHANA · 1996 to 2013
$3.5MGenetic Influences on ADHD in a Finnish Birth CohortR01MH063706 · NIMH · UNIVERSITY OF CALIFORNIA LOS ANGELES · PI SMALLEY, SUSAN L · 2001 to 2005
$3.3MSocioeconomic gradient in CHD in early old ageR01HL036310 · NHLBI · UNIVERSITY OF LONDON · PI KIVIMAKI, MIKA J, MARMOT, MICHAEL G · 1986 to 2012
$3.1MPsychometric and Genetic Assessments of Substance UseR01DA018673 · NIDA · VIRGINIA COMMONWEALTH UNIVERSITY · PI NEALE, MICHAEL CHURTON · 2004 to 2019
$2.3MWhole Genome Assoc. Analysis Strategies for Multi. PhenotypesRL1MH083268 · NIMH · UNIVERSITY OF CALIFORNIA LOS ANGELES · PI FREIMER, NELSON B. · 2007 to 2011
$2.1MUncovering and confirming gene-environment interactions in psychopathologyR01MH077874 · NIMH · DUKE UNIVERSITY · PI CASPI, AVSHALOM · 2007 to 2010
$1.6MA Developmental Model of Gene-Environment Interplay in SUDsR01DA024413 · NIDA · DUKE UNIVERSITY · PI COSTELLO, ELIZABETH JANE · 2011 to 2011
$1.2MAHRQ HHS HS06516British Heart Foundation PG/07/131/24254British Heart Foundation PG/09/022/26739British Heart Foundation PG/13/66/30442British Heart Foundation RG/08/013/25942British Heart Foundation RG/13/16/30528Chief Scientist Office CZD/16/6/4Department of Health 0090049European Research Council 284167Medical Research Council G0000934Medical Research Council G0100266Medical Research Council G0500539Medical Research Council G0600705Medical Research Council G0800612Medical Research Council G0802736Medical Research Council G1001799Medical Research Council G1002319Medical Research Council MC_PC_15018Medical Research Council MC_PC_U127561128Medical Research Council MC_UU_12013/1Medical Research Council MC_UU_12013/6Medical Research Council MC_UU_12019/1Medical Research Council MR/J012165/1Medical Research Council MR/J01351X/1Medical Research Council MR/K023195/1Medical Research Council MR/K023233/1Medical Research Council MR/K026992/1NCATS NIH HHS UL1 TR001425NHLBI NIH HHS HL36310NHLBI NIH HHS R01 HL036310NHLBI NIH HHS R01 HL087679NIA NIH HHS AG13196NIA NIH HHS R01 AG013196NIA NIH HHS R01 AG017644NIA NIH HHS R01AG1764406S1NIA NIH HHS R37 AG013196NIDA NIH HHS R01 DA018673NIDA NIH HHS R01 DA024413NIDA NIH HHS R01DA024413NIDDK NIH HHS U01 DK062418NIMH NIH HHS 1RL1MH083268-01NIMH NIH HHS MH077874NIMH NIH HHS R01 MH063706NIMH NIH HHS R01 MH077874NIMH NIH HHS RL1 MH083268Wellcome Trust 068545/Z/02Wellcome Trust 076113Wellcome Trust 086684Wellcome Trust 092731Wellcome Trust 102215
Abstract
objectivesTo investigate whether associations of smoking with depression and anxiety are likely to be causal, using a Mendelian randomisation approach.
designMendelian 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.
participantsCurrent, 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.
resultsThe 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.
conclusionsFindings from Mendelian randomisation analyses do not support a causal role of smoking heaviness in the development of depression and anxiety.
Indexed as
AdolescentAdultAgedAnxietyAnxiety DisordersCausalityDepressionDepressive DisorderFemaleHumansMaleMendelian Randomization AnalysisMiddle AgedNerve Tissue ProteinsReceptors, NicotinicSmokingCHRNA5 protein, humanCHRNB4 protein, humanNerve Tissue ProteinsReceptors, NicotinicAnxietyDepressionMendelian randomisationSmoking
Identifiers
What OpenQuestion holds
Textmetadata
LicenceCC BY
Read underepoch 390
Registered trials
None linked
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.