To investigate the relationship between smoking exposure and cervical cancer risk by integrating observational and genetic evidence.
We analyzed data from the National Health and Nutrition Examination Survey (1999–2018) and performed a genetic instrumental variable analysis using genome-wide association studies data. Smoking exposure was assessed using self-reported status and serum cotinine concentrations. Logistic regression models were used to evaluate observational associations, while inverse variance weighting was used for genetic analysis.
Observational analysis showed that current smokers had a significantly higher cervical cancer risk than nonsmokers and former smokers (adjusted odds ratio = 3.05, 95% confidence interval: 1.61–5.78, p < 0.001). Higher serum cotinine concentrations were also positively associated with cervical cancer risk. Genetic analysis further supported a causal link between smoking exposure and cervical cancer.
Smoking exposure significantly increases cervical cancer risk, emphasizing the importance of smoking cessation for prevention of cervical cancer. Incorporating tobacco control into cervical cancer prevention strategies could reduce disease burden.