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Cigarette Smoking Behavior a Gateway to Opium Use Disorder: A Mendelian Randomization Analysis

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Abstract

Gateway hypothesis presumes that using a psychotropic drug can increase the probability of using another drug. The study was to assess whether cigarette smoking is a gateway drug for subsequent opium use. Mendelian randomization (MR) analysis was applied to test and estimate the size of causal effect of cigarette smoking on opium use. The CHRNA3 rs1051730 polymorphism was used as an instrumental variable. A population-based case control study in the setting of Fasa Cohort Study was carried out using 477 cases and 531 controls based on their opium use status at the baseline of cohort study. The logistic two stage estimator method was applied. The Number of cigarettes smoked per day was associated with opium use (OR 1.17, 95% CI 1.15–1.19). In the MR analysis, rs1051730 T alleles were associated with increased risk of opium use among ever smokers (OR 5.73, 95% CI 1.72–19.07) however there found no evidence of association among never smokers. In instrumental variable analysis, showed that on average smoking every 1 more cigarette per day increases the odds of opium use by 1.17 (OR 1.17, 95%CI:1.14–1.19). The MR analysis found a positive finding on the relationship between cigarette smoking and opium use which supports the gateway hypothesis. It adds new information to the gateway theory regarding the relation of cigarette smoking and drug use, and increases our understanding of the importance of tobacco control for prevention of opium addiction.

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Funding

This study was funded by Iran University of Medical Sciences (Grant No. 9221128205).

Author information

Author notes

  1. Azadeh Shojaei and Seyed Abbas Motevalian are jointly supervised this work.

Authors and Affiliations

  1. Department of Health Management and Social Development Research Center, Golestan University of Medical Sciences, Gorgan, Iran

    Abdolhalim Rajabi

  2. Department of Epidemiology, School of Public Health, Iran University of Medical Sciences, Shahid Hemmat Highway, Tehran, Iran

    Abdolhalim Rajabi, Hamid Reza Baradaran & Seyed Abbas Motevalian

  3. Department of Medical Genetics and Molecular Biology, Faculty of Medicine, Iran University of Medical Sciences, Shahid Hemmat Highway, Tehran, Iran

    Azadeh Shojaei

  4. Department of Biostatistics, School of Public Health, Iran University of Medical Sciences, Tehran, Iran

    Leila Janani

  5. Non-Communicable Diseases Research Center, Fasa University of Medical Sciences, Fasa, Iran

    Mojtaba Farjam

  6. Ageing Clinical & Experimental Research Team, Institute of Applied Health Sciences, University of Aberdeen, Aberdeen, UK

    Hamid Reza Baradaran

  7. Medical Genetic Laboratory, Shahid Akbarabadi Hospital, Iran University of Medical Sciences, Tehran, Iran

    Pedram Khosravi

  8. Research Center for Addiction and Risky Behaviors (ReCARB), Psychosocial Health Research Institute, Iran University of Medical Sciences, Tehran, Iran

    Seyed Abbas Motevalian

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  1. Abdolhalim Rajabi
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Contributions

Abdolhalim Rajabi, Seyed Abbas Motevalian and Azadeh Shojaei contributed to the study conception and design. Material preparation, data collection and analysis were performed by Abdolhalim Rajabi, Leila Janani, Mojtaba Farjam, Pedram Khosravi and Hamid Reza Baradaran. The first draft of the manuscript was written by Abdolhalim Rajabi and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding authors

Correspondence to Azadeh Shojaei or Seyed Abbas Motevalian.

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Conflict of interest

Abdolhalim Rajabi, Azadeh Shojaei, Leila Janani, Mojtaba Farjam, Hamid Reza Baradaran, Pedram Khosravi and Seyed Abbas Motevalian declare that they have no conflict of interest.

Human and Animal Rights and Informed consent

The study has been performed in accordance with the Declaration of Helsinki. Written informed consent was obtained from all individual participants in the study.

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Rajabi, A., Shojaei, A., Janani, L. et al. Cigarette Smoking Behavior a Gateway to Opium Use Disorder: A Mendelian Randomization Analysis. Behav Genet 51, 385–393 (2021). https://doi.org/10.1007/s10519-021-10052-0

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  • DOI: https://doi.org/10.1007/s10519-021-10052-0

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