Evidence for a Causal Relationship Between Academic Achievement and Cigarette Smoking

Area of Science:

• Epidemiology
• Public Health
• Behavioral Science

Background:

• Academic achievement (AA) is known to be associated with smoking rates.
• The causal nature of this relationship requires further investigation.

Purpose of the Study:

• To determine the causal effect of academic achievement on smoking rates.
• To explore the impact of AA on smoking cessation in specific populations.

Main Methods:

• Instrumental variable (IV) analyses utilizing month-of-birth as an instrument for AA.
• Co-relative analyses using familial data (cousins, siblings) to control for confounding factors.
• Prediction of smoking in male conscripts and pregnant females based on AA.

Main Results:

• Higher AA was associated with a significant decrease in smoking risk in males (OR=0.41).
• Consistent evidence for a causal effect of AA on reduced smoking and increased cessation was found in pregnant females across different analytical methods.
• Specifically, for females smoking prior to pregnancy, AA predicted reduced continued smoking (ORs ranging from 0.54 to 0.78).

Conclusions:

• Higher academic achievement causally reduces smoking rates and increases smoking cessation in pregnant women.
• Interventions aimed at improving educational achievement in adolescence may lead to substantial public health gains through reduced tobacco consumption.