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Genetics are critical in a persons likelihood to begin smoking, accounting for about 75% of the inclination, as mentioned by psychologist Lerman, PhD, from the University of Pennsylvania, as included in the American Psychological Associations (2008) Genes Matter in Addiction. Peer influences , such as social groups and peer pressure encourage smoking, especially during adolescence or early adulthood

Recent advances in MR methodology, such as multivariable MR, have further enabled the estimation of mediation effects within the MR framework by allowing for the simultaneous modeling of multiple exposures