Role of obesity in smoking behaviour: Mendelian randomisation study in UK Biobank [肥胖在吸烟行为种的作用：基于英国生物库的孟德尔随机化研究]

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BMJ 2018; 361 doi: https://doi.org/10.1136/bmj.k1767 (Published 16 May 2018)
Cite this as: BMJ 2018;361:k1767

Authors
Robert Carreras-Torres, Mattias Johansson, Philip C Haycock, Caroline L Relton, George Davey Smith, Paul Brennan, Richard M Martin

Abstract
Objective To determine whether body mass index, body fat percentage, and waist circumference influence smoking status and intensity.

Design Mendelian randomisation study.

Setting UK Biobank, with replication of results from the Tobacco and Genetics (TAG) consortium.

Participants European descent participants from the UK Biobank cohort (n=372 791) and the TAG consortium (n=74 035).

Main outcome measures Risk of current and past smoking, number of cigarettes smoked per day, age of smoking initiation.

Results The Mendelian randomisation analysis indicated that each standard deviation increment in body mass index (4.6) increased the risk of being a smoker (odds ratio 1.18 (95% confidence interval 1.13 to 1.23), P<0.001). This association was replicated in the TAG consortium data (1.19 (1.06 to 1.33), P=0.003). Furthermore, each standard deviation increment in body mass index was estimated to increase smoking intensity by 0.88 cigarettes per day (95% confidence interval 0.50 to 1.26, P<0.001) in UK Biobank and 1.27 cigarettes per day in the TAG consortium (0.46 to 2.07, P=0.002). Similar results were also seen for body fat percentage and waist circumference in both UK Biobank and the TAG consortium data.

Conclusions These results strongly suggest that higher adiposity influences smoking behaviour and could have implications for the implementation of public health interventions aiming to reduce the prevalence of these important risk factors.