Communications medicine最新文献

{"title":"Longitudinal study of risk factors predicting cannabis use disorder in UK young adults and adolescents.","authors":"Martine Skumlien, Darcy Jones, Claire Mokrysz, Rachel Lees, Kat Petrilli, Shelan Ofori, Will Lawn, H Valerie Curran, Tom P Freeman","doi":"10.1038/s43856-025-01018-y","DOIUrl":"10.1038/s43856-025-01018-y","url":null,"abstract":"<p><strong>Background: </strong>Cannabis use disorder (CUD) affects up to 1 in 5 people who try cannabis. In order to develop effective interventions to prevent and treat CUD, it is important to identify the factors that predict it. This longitudinal study investigated whether eight potential risk factors predicted CUD levels at 12-month follow-up.</p><p><strong>Methods: </strong>Participants were 232 young adults (26-29 years) and adolescents (16-17 years) (48%/52% males/females) who took part in both the baseline and 12-month follow-up sessions of the London-based 'CannTeen' study. Half of the participants (n = 117) used cannabis 1-7 days/week at baseline and the other half had used cannabis maximum 10 times in their life. CUD was measured with the Mini Neuropsychiatric interview for DSM-5 CUD, which was used to categorise participants into no, mild, moderate, or severe CUD levels. Ordinal logistic regression was used to explore whether baseline CUD (yes/no), age-group, gender, days/week of cannabis use, problematic alcohol use, problematic tobacco use, past-year negative life events, and the COVID-19 lockdown predicted 12-month CUD levels in the full sample and in only those who used cannabis minimum once per week at baseline.</p><p><strong>Results: </strong>Here we show that adolescent age (odds ratio = 3.26, p < 0.001) and CUD at baseline (odds ratio = 45.15, p < 0.001) predict higher CUD levels at follow-up. We do not find evidence to support associations with other factors. The same pattern of results is found when including only participants who used cannabis at baseline.</p><p><strong>Conclusions: </strong>CUD prevention and treatment should be targeted towards adolescents, who have a significantly greater risk of CUD than young adults.</p>","PeriodicalId":72646,"journal":{"name":"Communications medicine","volume":"5 1","pages":"300"},"PeriodicalIF":5.4,"publicationDate":"2025-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12276291/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144669030","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lifetime risk, sex and age differences in annual incidence of ocular motor cranial nerve palsy in Japan for 2019.","authors":"Manabu Miyata, Ai Kido, Masahiro Miyake, Hiroshi Tamura, Takuro Kamei, Saori Wada, Hiroaki Ueshima, Shinya Nakao, Akinari Yamamoto, Kenji Suda, Eri Nakano, Miho Tagawa, Yuki Mori, Akitaka Tsujikawa","doi":"10.1038/s43856-025-01027-x","DOIUrl":"10.1038/s43856-025-01027-x","url":null,"abstract":"<p><strong>Background: </strong>We aimed to demonstrate the incidence and subtype proportions of ocular motor cranial nerve palsy (OMCNP) by age group and sex, and to estimate the associated lifetime risks in the Japanese population.</p><p><strong>Methods: </strong>This nationwide, population-based, cross-sectional cohort study utilized data from the National Database of Health Insurance Claims and Specific Health Checkups of Japan, provided by the Ministry of Health, Labour and Welfare, covering almost all (≥95%) claims. We identified newly diagnosed OMCNP cases (oculomotor, trochlear, or abducens palsy) between January 1 and December 31, 2019, separated by sex and age category (5-year steps). We calculated the incidence rate as the proportion relative to the Japanese population, and calculated the lifetime risk. Furthermore, we calculated the age-standardized incidence rate and lifetime risk according to the world population distribution.</p><p><strong>Results: </strong>The crude incidence rate of OMCNP is 17.36 (oculomotor palsy, 6.62 [38.1%]; trochlear palsy, 2.61 [15.0%]; abducens palsy, 8.14 [46.9%]) per 100,000 person-years. The incidence rate increases with age and is higher in men than in women (19.91 vs. 14.96). The lifetime risks of oculomotor, trochlear, and abducens palsies are 0.50%, 0.19%, and 0.61%, respectively. The age-standardized incidence rates of oculomotor, trochlear, and abducens palsies are 3.25 (lifetime risk, 0.35%), 1.28 (lifetime risk, 0.13%), and 4.60 (lifetime risk, 0.45%) per 100,000 person-years, respectively.</p><p><strong>Conclusions: </strong>This nationwide study of >100 million people reveals that OMCNP incidence increases with age and is higher in men. Approximately one in 100 individuals is affected in their lifetime. Our comprehensive analysis of OMCNP demographics provides important information for addressing healthcare, particularly for older people, from social and public health perspectives.</p>","PeriodicalId":72646,"journal":{"name":"Communications medicine","volume":"5 1","pages":"299"},"PeriodicalIF":5.4,"publicationDate":"2025-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12276285/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144669029","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"High diversity of Escherichia coli causing invasive disease in neonates in Malawi poses challenges for O-antigen based vaccine approach.","authors":"Oliver Pearse, Allan Zuza, Edith Tewesa, Patricia Siyabu, Alice J Fraser, Jennifer Cornick, Kondwani Kawaza, Patrick Musicha, Nicholas R Thomson, Nicholas A Feasey, Eva Heinz","doi":"10.1038/s43856-025-01007-1","DOIUrl":"10.1038/s43856-025-01007-1","url":null,"abstract":"<p><strong>Background: </strong>Escherichia coli is an important cause of neonatal sepsis and the third most prevalent cause of neonatal infection in sub-Saharan Africa, often with negative outcomes. Development of maternally administered vaccines is under consideration, but to provide adequate protection, an understanding of serotypes causing invasive disease in this population is essential. We describe the genomic characteristics of a collection of neonatal E. coli isolates from a tertiary hospital in Blantyre, Malawi, with specific reference to potential protection by vaccines under development.</p><p><strong>Methods: </strong>Neonatal blood or cerebrospinal fluid cultures from 2012 to 2021 identified 208 E. coli isolates, and 169 could be recovered for sequencing.</p><p><strong>Results: </strong>Our data shows very high diversity in sequence types, LPS O-antigen-type and flagellar H-type, which all show temporal fluctuations and, as far as we are aware previously undescribed diversity, including ten putative novel O-types. Vaccines in clinical trials target the O-antigen but would only protect against less than half (37.9%) of neonatal sepsis cases in this population (EXPEC9V). An O-antigen-based vaccine would require 30 different O-types to protect against 80% of infections.</p><p><strong>Conclusions: </strong>Vaccines against neonatal sepsis in Africa are of considerable potential value, but their development requires larger studies to establish the diversity and stability over time of relevant O-types for this population.</p>","PeriodicalId":72646,"journal":{"name":"Communications medicine","volume":"5 1","pages":"298"},"PeriodicalIF":5.4,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12274568/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144669028","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rising prevalence of Plasmodium falciparum Artemisinin partial resistance mutations in Ethiopia.","authors":"Bokretsion G Brhane, Abebe A Fola, Helen Nigussie, Alec Leonetti, Moges Kassa, Henok Hailgiorgis, Yonas Wuletaw, Adugna Abera, Hussein Mohammed, Heven Sime, Abeba G/Tsadik, Gudissa Assefa, Hiwot Solomon, Geremew Tasew, Getachew Tollera, Mesay Hailu, Jonathan J Juliano, Ashenafi Assefa, Jonathan B Parr, Jeffrey A Bailey","doi":"10.1038/s43856-025-01008-0","DOIUrl":"10.1038/s43856-025-01008-0","url":null,"abstract":"<p><strong>Background: </strong>Ethiopia aims to eliminate local malaria transmission by 2030, but rising malaria cases, due to different factors, present a challenge. Understanding the prevalence and distribution of artemisinin partial resistance (ART-R) and other markers related to partner drugs as well as parasite connectivity in Ethiopia can greatly inform malaria control.</p><p><strong>Methods: </strong>We analyzed 1199 clinical Plasmodium falciparum infections from 12 sentinel sites across five regions in Ethiopia, collected between 2019 and 2023. Using two molecular inversion probe (MIP) panels targeting key drug resistance genes and genome-wide SNPs, we assessed the prevalence of resistance-associated mutations, complexity of infection (COI), and parasite relatedness through identity-by-descent (IBD) and principal component analysis (PCA).</p><p><strong>Results: </strong>The most prevalent k13 R622I mutation appears in 15.7% of samples, with marked regional variation. Three validated ART-R mutations (P441L, P574L, A675V) are detected in Ethiopia for the first time, as far as we are aware, with A675V found exclusively in a Gambella clinic serving refugees from Sudan and South Sudan. Additionally, polymorphisms associated with resistance to partner drugs, including those in crt, mdr1, dhps, and dhfr genes, are nearly fixed. Most samples (87.2%) consist of monogenomic infections (COI = 1), and mutant parasites show high local genetic relatedness at the health facility level, suggesting clonal transmission. PCA reveals regional clustering, particularly in Gambella, highlighting the influence of local drug pressure, regional transmission dynamics, and importation as drivers of the observed drug resistance patterns.</p><p><strong>Conclusions: </strong>The increasing prevalence of k13 R622I and the emergence of additional ART-R mutations underscore the urgent need for enhanced ACT efficacy monitoring. Early detection of partner drug resistance and ACT failure will be essential to address malaria resurgence and support Ethiopia's elimination goals.</p>","PeriodicalId":72646,"journal":{"name":"Communications medicine","volume":"5 1","pages":"297"},"PeriodicalIF":5.4,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12274420/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144669031","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Transformer-based structural connectivity networks for ADHD-related connectivity alterations.","authors":"Liting Shi, Lei Shi, Zhijun Cui, Chengting Lin, Rui Zhang, Jiayi Zhang, Yechen Zhu, Wei Shi, Jianlin Wang, Yanlong Wang, Dongxing Wang, Haihong Liu, Xin Gao","doi":"10.1038/s43856-025-01015-1","DOIUrl":"10.1038/s43856-025-01015-1","url":null,"abstract":"<p><strong>Background: </strong>Attention-deficit/hyperactivity disorder (ADHD) is a common neurodevelopmental disorder that affects behavior, attention, and learning. Current diagnoses rely heavily on subjective assessments, underscoring the need for objective imaging-based methods. This study aims to explore whether structural connectivity networks derived from MRI can reveal alterations associated with ADHD and support data-driven understanding.</p><p><strong>Methods: </strong>We collected brain MRI data from 947 individuals (aged 7-26 years; 590 males, 356 females, 1 unspecified) across eight centers, sourced from the Neuro Bureau ADHD-200 preprocessed dataset. Transformer-based deep learning models were used to learn relationships between different brain regions and construct structural connectivity networks. To prepare input for the model, each region was transformed into a standardized data sequence using four different strategies. The strength of connectivity between brain regions was then measured to identify structural differences related to ADHD. Five-fold cross-validation and statistical analyses were used to evaluate model robustness and group differences, respectively.</p><p><strong>Results: </strong>Here we show that the proposed method performs well in distinguishing ADHD individuals from healthy controls, with accuracy reaching 71.9 percent and an area under curve of 0.74. The structural networks also reveal significant differences in connectivity patterns (paired t-test: P = 0.81 × 10^-6), particularly involving regions responsible for motor and executive function. Notably, the importance rankings of several brain regions, including the thalamus and caudate, differ markedly between groups.</p><p><strong>Conclusions: </strong>This study shows that ADHD may be associated with connectivity alterations in multiple brain regions. Our findings suggest that brain structural connectivity networks built using Transformer-based methods offer a promising tool for both diagnosis and further research into brain structure.</p>","PeriodicalId":72646,"journal":{"name":"Communications medicine","volume":"5 1","pages":"296"},"PeriodicalIF":5.4,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12271470/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144661150","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Machine-learning of medical cannabis chemical profiles reveals analgesia beyond placebo expectations.","authors":"Adi Hatav, Yelena Vysotski, Anna Shapira, Shiri Procaccia, David Meiri, Dvir Aran","doi":"10.1038/s43856-025-00996-3","DOIUrl":"10.1038/s43856-025-00996-3","url":null,"abstract":"<p><strong>Background: </strong>The efficacy of medical cannabis in alleviating pain has been demonstrated in clinical trials, yet questions remain regarding the extent to which specific chemical compounds contribute to analgesia versus expectation-based (placebo) responses. Effective blinding is notoriously difficult in cannabis trials, complicating the identification of compound-specific effects.</p><p><strong>Methods: </strong>In a prospective study of 329 chronic pain patients (40% females; aged 48.9 ± 15.5) prescribed medical cannabis, we examined whether the chemical composition of cannabis cultivars could predict treatment outcomes. We used a Random Forest classifier with nested cross-validation to assess the predictive value of demographics, clinical features, and approximately 200 chemical compounds. Model robustness was evaluated using six additional machine learning algorithms.</p><p><strong>Results: </strong>Here we show that incorporating chemical composition markedly improves the prediction of pain relief (AUC = 0.63 ± 0.10) compared to models using only demographic and clinical features (AUC = 0.52 ± 0.09; p < 0.001). This result is consistent across all models tested. While well-known cannabinoids such as THC and CBD provide limited predictive value, specific terpenoids, particularly α-Bisabolol and eucalyptol, emerge as key predictors of treatment response.</p><p><strong>Conclusions: </strong>Our findings demonstrate that pain relief can be predicted from cannabis chemical profiles that are unknown to patients, providing evidence for compound-specific therapeutic effects. These results highlight the importance of considering the full range of cannabis compounds when developing more precise and effective cannabis-based therapies for pain management.</p>","PeriodicalId":72646,"journal":{"name":"Communications medicine","volume":"5 1","pages":"295"},"PeriodicalIF":5.4,"publicationDate":"2025-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12267634/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144651384","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A diffusion model for universal medical image enhancement.","authors":"Ben Fei, Yixuan Li, Weidong Yang, Hengjun Gao, Jingyi Xu, Lipeng Ma, Yatian Yang, Pinghong Zhou","doi":"10.1038/s43856-025-00998-1","DOIUrl":"10.1038/s43856-025-00998-1","url":null,"abstract":"<p><strong>Background: </strong>The development of medical imaging techniques has made a significant contribution to clinical decision-making. However, the existence of suboptimal imaging quality, as indicated by irregular illumination or imbalanced intensity, presents significant obstacles in automating disease screening, analysis, and diagnosis. Existing approaches for natural image enhancement are mostly trained with numerous paired images, presenting challenges in data collection and training costs, all while lacking the ability to generalize effectively.</p><p><strong>Methods: </strong>Here, we introduce a pioneering training-free Diffusion Model for Universal Medical Image Enhancement, named UniMIE. UniMIE demonstrates its unsupervised enhancement capabilities across various medical image modalities without the need for any fine-tuning. It accomplishes this by relying solely on a single pre-trained model from ImageNet.</p><p><strong>Results: </strong>We conduct a comprehensive evaluation on 13 imaging modalities and over 15 medical types, demonstrating better qualities, robustness, and accuracy than other modality-specific and data-inefficient models. By delivering high-quality enhancement and corresponding accuracy downstream tasks across a wide range of tasks, UniMIE exhibits considerable potential to accelerate the advancement of diagnostic tools and customized treatment plans.</p><p><strong>Conclusions: </strong>UniMIE represents a transformative approach to medical image enhancement, offering a versatile and robust solution that adapts to diverse imaging conditions. By improving image quality and facilitating better downstream analyses, UniMIE has the potential to revolutionize clinical workflows and enhance diagnostic accuracy across a wide range of medical applications.</p>","PeriodicalId":72646,"journal":{"name":"Communications medicine","volume":"5 1","pages":"294"},"PeriodicalIF":5.4,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12264189/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144644273","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The importance of funding and investment to strengthen data science in Africa.","authors":"Hazal Kayalioglu, John Pateña, Raphael Z Sangeda, Upendo Masamu, Bruno Mmbando, Belinda Njiro, Conrad Iyegbe, Joyce Gyamfi, Dorice Vieira, Emmanuel Peprah","doi":"10.1038/s43856-025-01001-7","DOIUrl":"10.1038/s43856-025-01001-7","url":null,"abstract":"","PeriodicalId":72646,"journal":{"name":"Communications medicine","volume":"5 1","pages":"293"},"PeriodicalIF":5.4,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12259852/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144638830","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Characterizing aging-related genetic and physiological determinants of spinal curvature.","authors":"Frances M Wang, J Graham Ruby, Anurag Sethi, Matthew A Veras, Natalie Telis, Eugene Melamud","doi":"10.1038/s43856-025-01003-5","DOIUrl":"10.1038/s43856-025-01003-5","url":null,"abstract":"<p><strong>Background: </strong>Increased spinal curvature is one of the most recognizable aging traits in the human population. However, despite high prevalence, the etiology of this condition remains poorly understood.</p><p><strong>Methods: </strong>To gain better insight into the physiological, biochemical, and genetic risk factors involved, we developed a novel machine learning method to automatically derive thoracic kyphosis and lumbar lordosis angles from dual-energy X-ray absorptiometry (DXA) scans in the UK Biobank Imaging cohort. We carry out genome-wide association and epidemiological association studies to identify genetic and physiological risk factors for both traits.</p><p><strong>Results: </strong>In 41,212 participants, we find that on average males and females gain 2.42° in kyphotic and 1.48° in lordotic angle per decade of life. Increased spinal curvature shows a strong association with decreased muscle mass and bone mineral density. Adiposity demonstrates opposing associations, with decreased kyphosis and increased lordosis. Using Mendelian randomization, we show that genes fundamental to the maintenance of musculoskeletal function (COL11A1, PTHLH, ETFA, TWIST1) and cellular homeostasis such as RNA transcription and DNA repair (RAD9A, MMS22L, HIF1A, RAB28) are likely involved in increased spinal curvature.</p><p><strong>Conclusions: </strong>Our findings reveal a complex interplay between genetics, musculoskeletal health, and age-related changes in spinal curvature, suggesting potential drivers of this universal aging trait.</p>","PeriodicalId":72646,"journal":{"name":"Communications medicine","volume":"5 1","pages":"291"},"PeriodicalIF":5.4,"publicationDate":"2025-07-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12255709/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144621503","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A cross-national analysis of childhood predictors of daily smoking in adulthood.","authors":"Sung Joon Jang, Pedro A de la Rosa, R Noah Padgett, Matt Bradshaw, Tyler J VanderWeele, Byron R Johnson","doi":"10.1038/s43856-025-01005-3","DOIUrl":"10.1038/s43856-025-01005-3","url":null,"abstract":"<p><strong>Background: </strong>Prior research on childhood predictors of cigarette smoking tends to focus on the prevalence rather than the quantity of smoking and rarely examined these predictors separately for smokers. Also scarce is cross-national research synthesizing the effects of childhood predictors.</p><p><strong>Methods: </strong>Using survey data from the Global Flourishing Study of 202,898 adults, weighted to be nationally representative of populations in 21 countries and one territory, we created continuous and binary measures of daily cigarette consumption in adulthood. The binary measure of daily smoking was regressed on childhood and demographic variables for the total sample, and the continuous measure was analyzed for the sample of smokers.</p><p><strong>Results: </strong>Random effects meta-analysis provides evidence that childhood maternal and paternal relationship quality (both total and smoker samples), religious service attendance (smoker sample), and being foreign-born (both samples) predict a lower likelihood of adult smoking, whereas being raised by a divorced parent (total sample), having been abused and/or an outsider in the family (both samples), and poor health growing up (both samples) predict a higher likelihood. Although effects are generally weak and mixed in some cases, their direction and strength tend to be consistent between the two samples as well as alternative measures of smoking with some exceptions. Overall, our findings are moderately robust against potential unmeasured confounding, while the effect sizes vary across countries.</p><p><strong>Conclusions: </strong>The present study offers an important new set of global findings based on a large-scale cross-national study of daily cigarette smoking and country-specific variations.</p>","PeriodicalId":72646,"journal":{"name":"Communications medicine","volume":"5 1","pages":"292"},"PeriodicalIF":5.4,"publicationDate":"2025-07-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12255748/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144621501","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}