By U.S. Department of Health and Human Services.
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Extra resources for The Health Consequences of Smoking: A Report of the Surgeon General.
The committee acknowledged that smoking does not always result in lung cancer and that lung cancer has other causes. ” Temporality Temporality refers to the occurrence of a cause before its purported effect. Temporality is the sine qua non of causality, as a cause clearly cannot occur after its purported effect. Failure to establish temporal sequence seriously weakens a causal claim, but establishing temporal precedence is by itself not very strong evidence in favor of causality. Coherence, Plausibility, and Analogy Although the original definitions of these criteria were subtly different, in practice they have been treated essentially as one idea: that a proposed causal relationship not violate known scientific principles, and that it be consistent with experimentally 22 Chapter 1 demonstrated biologic mechanisms and other relevant data, such as ecologic patterns of disease (Rothman and Greenland 1998).
Without randomization, there is no mathematic basis to assume that imbalance in unknown confounders will decrease with an increase in the number of studies. For example, many observational studies of HRT use in women have shown a strong cardioprotective effect. If unmeasured cardioprotective characteristics are consistently more common among women who use HRT, then having multiple studies will not necessarily reduce the effect of unmeasured confounding. , therapeutic HRT use after hysterectomy), each of which might eliminate another source of confounding from consideration, then confidence that unmeasured confounders are not producing the findings is increased.
Wheezing) in childhood and adolescence. 14. The evidence is inadequate to infer the presence or absence of a causal relationship between active smoking and physician-diagnosed asthma in childhood and adolescence. 15. The evidence is suggestive but not sufficient to infer a causal relationship between active smoking and a poorer prognosis for children and adolescents with asthma. Introduction and Approach to Causal Inference 27 Surgeon General’s Report 16. The evidence is sufficient to infer a causal relationship between active smoking and all major respiratory symptoms among adults, including coughing, phlegm, wheezing, and dyspnea.