Higher Cigarettes Predicts Slightly Higher Anxiety for Population

Higher Cigarettes Predicts Slightly Higher Anxiety for Population

Contents

Variables

A
Cigarettes 107
A
Anxiety / Nervousness 1826

Categories

A
Treatments 9356
A
Emotions 2028

Tags

Medium Confidence
Very Weak Effect Size
Positive Relationship
Population Study
cause image gauge image effect image
Participants reported a 13.6% average increase in Anxiety following above average Cigarettes.

Abstract

Anxiety was generally 8.6% higher than average after 11.4 count of Cigarettes per 21 days.

Aggregated data from 5 study participants suggests with a MEDIUM degree of confidence (p=0.154, 95% CI -0.334 to 0.593) that Cigarettes has a weakly positive predictive relationship (R=0.13) with Anxiety.

The highest quartile of Anxiety measurements were observed following an average 13.9 count Cigarettes per day.

The lowest quartile of Anxiety measurements were observed following an average 15.2 count of Cigarettes per day.

After an onset delay of 30 minutes, Anxiety is typically 5% lower than average over the 21 days following around 15.2 count of Cigarettes Cigarettes.

Keywords: Cigarettes, Anxiety, N-of-1 trials, real-world evidence, causal inference, observational study

Preliminary: Based on 5 participants. Results may change as more data is collected.

Results

Primary Findings

Analysis of 104 paired observations from 5 participants revealed a modest improvement in Anxiety following above-average Cigarettes exposure.

+8.6%
Change from Baseline
Modest effect on Anxiety
0.05
Predictor Impact Score
Insufficient evidence for causal relationship

Supporting Statistics

Medium
Confidence
0.130
Correlation (r)
p = 0.196
Significance
z = 0.94
Effect Magnitude
φ = 1.00
Temporality

What This Means

When participants had above-average Cigarettes:

  • Anxiety increased by 8.6% on average
  • Temporal analysis supports Cigarettes as the predictor (not the outcome)

Interpreting the Predictor Impact Score

The Predictor Impact Score (PIS) integrates multiple Bradford Hill causal criteria into a single metric. Use this guide to interpret the score:

PIS Range Interpretation Recommended Action
≥ 0.5 Strong evidence High priority for RCT validation
0.3 - 0.5 Moderate evidence Consider for experimental investigation
0.1 - 0.3 Weak evidence Monitor for additional data
< 0.1 Insufficient evidence Low priority; may be noise

Note: PIS is a prioritization heuristic, not proof of causation. High scores indicate relationships worth investigating, not confirmed causal effects. With only 5 participants, these scores are preliminary and will become more reliable as additional data is collected.

Optimal Daily Values

No clear dose-response relationship detected. The Cigarettes values associated with high and low Anxiety are too similar to provide meaningful dosing guidance. This may indicate a threshold effect (any amount works equally well), no effect, or insufficient data variance. With more participants, a clearer pattern may emerge.

Population Correlation

Cigarettes Distribution

Anxiety Distribution

Relationship Analysis

Statistical Summary

Relationship Statistics

Property Value
Cause Variable Name Cigarettes
Effect Variable Name Anxiety
Sinn Predictive Coefficient 0.051072323024135
Confidence Level MEDIUM
Confidence Interval 0.46349
Forward Pearson Predictive Coefficient 0.1298
Critical T Value 1.698
Total Cigarettes Over Previous 21 days Before ABOVE Average Anxiety 13.9 count
Total Cigarettes Over Previous 21 days Before BELOW Average Anxiety 15.2 count
Duration of Action 21 days
Effect Size weakly positive
Number of Paired Measurements 104
Optimal Pearson Product 0.050434555980169
P Value 0.15423
Statistical Significance 0.1958
Strength of Relationship 0.46349
Study Type population
Analysis Performed At 2026-01-04
Number of Participants 5

Cigarettes Info

Property Value
Variable Name Cigarettes (count)
Aggregation Method SUM
Analysis Performed At 2020-10-11
Duration of Action 21 days
Filling Value 0
Kurtosis 17.295987554526
Mean 3.1074830971731 count
Median 2.6071428571429 count
Minimum Allowed Value 0 count
Number of Aggregate Predictors 0
Number of Aggregate Outcomes 107
Number of Measurements 1030
Number of Measurements (including those generated by tagged, joined, or child variables) 747
Public true
Onset Delay 30 minutes
Standard Deviation 1.8224185624311
Unit Count
User Variables 19
UPC 087273071753
Variable Category Treatments
Variable ID 1634381
Variance 6.9411006646222

Anxiety / Nervousness Info

Property Value
Variable Name Anxiety
Aggregation Method MEAN
Analysis Performed At 2022-10-07
Duration of Action 24 hours
Kurtosis 2.033986759222
Maximum Allowed Value 5 out of 5
Mean 3.0756713266762 out of 5
Median 3.0701780313837 out of 5
Minimum Allowed Value 1 out of 5
Number of Aggregate Predictors 1566
Number of Aggregate Outcomes 260
Number of Measurements 13546
Number of Measurements (including those generated by tagged, joined, or child variables) 13546
Public true
Onset Delay 0 seconds
Standard Deviation 0.31892876527387
Unit 1 to 5 Rating
User Variables 998
UPC 0
Variable Category Emotions
Variable ID 5903391
Variance 0.32180906187003

Introduction

Background

Cigarettes (Treatments) and Anxiety (Emotions) are both important factors in understanding human health and well-being. This study investigates the relationship between these two variables using real-world observational data.

Traditional randomized controlled trials (RCTs), while the gold standard for causal inference, are often impractical, expensive, or unethical for studying many health relationships. Aggregated N-of-1 observational studies offer a complementary approach that leverages within-subject comparisons across large populations to identify meaningful patterns.

Research Question

Do Cigarettes affect Anxiety?

Additionally, we seek to determine:

  1. What is the direction and magnitude of any effect?
  2. How confident can we be in this relationship based on the available data?
  3. What are the optimal levels of Cigarettes for maximizing Anxiety?

Study Objective

The objective of this study is to determine the nature of the relationship (if any) between Cigarettes and Anxiety. Additionally, we attempt to determine the Cigarettes (count) values most likely to produce optimal Anxiety values.

Study Overview

This is a population-level observational study using aggregated N-of-1 methodology. By aggregating individual N-of-1 experiments, we can identify population-level patterns while accounting for the substantial individual variation that exists in most health relationships. Effect sizes are reported as percent change from baseline, enabling intuitive interpretation and comparison across different measures.

Full Methodology: Framework for Real-World Evidence-Based Pharmacovigilance: Aggregated N-of-1 Trials for Quantifying Treatment Effects

Discussion

Interpretation of Findings

Participants experienced a 8.6% improvement in Anxiety following above-average Cigarettes exposure. The Predictor Impact Score (PIS) of 0.05 indicates insufficient evidence for a causal relationship.

Statistical Significance

Using a two-tailed t-test with alpha = 0.05, it was determined that the change in Anxiety is not statistically significant at a 95% confidence interval. This suggests that the Cigarettes value may not have a significant influence on the Anxiety value, or that more data is needed to detect an effect.

After treatment, a 13.6% increase (0.194 out of 5) from the mean baseline 1.83 out of 5 was observed. The relative standard deviation at baseline was 40.125%. The observed change was 0.94222 times the standard deviation.

A common rule of thumb considers a change greater than twice the baseline standard deviation on two separate pre-post experiments may be considered significant. This occurrence would have only a 5% likelihood of resulting from random fluctuation (a p-value < 0.05).

T-Test Details
Observed t-value: 1.629
Critical t-value: 1.698

Since t = 1.63 < 1.70, we cannot reject the null hypothesis.

Biological Plausibility

A plausible bio-chemical mechanism between predictor and outcome is critical for interpreting observational findings. This is where human judgment excels beyond statistical analysis.

Community feedback on the biological plausibility of this relationship is still being collected. Consider the known mechanisms by which Cigarettes might influence Anxiety.

Bradford Hill Criteria Assessment

The Bradford Hill criteria provide a framework for assessing causality in observational studies. Our methodology operationalizes six of the nine criteria through the Predictor Impact Score (PIS):

Criterion How Addressed Metric
Strength Effect size magnitude Percent change from baseline (Δ%), z-score
Consistency Cross-participant replication Number of users (N), number of pairs (n)
Temporality Predictor precedes outcome Temporality factor (φ), onset delay (δ > 0)
Biological Gradient Dose-response relationship Gradient coefficient (φgradient)
Plausibility Biological mechanism assessment Community votes on mechanism plausibility
Specificity Category appropriateness Interest factor (finterest)

Predictor Impact Score (PIS)

The PIS integrates multiple Bradford Hill criteria into a composite metric quantifying how reliably a predictor affects an outcome. Higher scores indicate stronger evidence:

Population-Level PIS:

$$\text{PIS}_{\text{agg}} = |r_{\text{forward}}| \cdot w \cdot \phi_{\text{users}} \cdot \phi_{\text{pairs}} \cdot \phi_{\text{change}} \cdot \phi_{\text{gradient}}$$

Where φ-factors are saturation functions approaching 1 as evidence accumulates:

  • φusers = 1 - e-N/10 (user saturation)
  • φpairs = 1 - e-n/nsig (pair saturation)
  • φchange = 1 - e-Δspread/Δsig (effect spread saturation)
  • w = weighted average of plausibility votes

Temporality Assessment

We assess evidence for correct causal direction using the temporality factor:

$$\phi_{\text{temporal}} = \frac{|r_{\text{forward}}|}{|r_{\text{forward}}| + |r_{\text{reverse}}|}$$

Values approaching 1 indicate the predictor precedes the outcome (supporting causation); values near 0.5 suggest ambiguous directionality; values near 0 suggest reverse causation or confounding by indication.

Limitations

As with any observational study, correlation does not prove causation. Key limitations include:

  • Unmeasured confounders: Variables not tracked may influence results
  • Self-selection bias: Health trackers may differ from the general population
  • Measurement error: Self-reported data may contain recall bias
  • Confounding by indication: Sicker individuals may use more treatments

However, within-subject comparison and temporal precedence analysis partially mitigate these limitations. If the relationship is merely coincidental, as participants independently modify their Cigarettes values, the observed strength will decline over time. Spurious correlations naturally dissipate as more data is collected.

Future Directions

Future research should examine:

  • Subgroup analyses to identify individual differences in response
  • Potential confounders and mediators of the observed relationship
  • Optimal dosing and timing for Cigarettes
  • Confirmation through prospective or randomized designs
  • Biological mechanisms underlying the observed effects

Conclusion

📊 Preliminary Findings: With 5 participants, these results are based on limited data. Effect sizes and confidence will improve as more participants contribute data. Consider these findings directional rather than definitive.

Above-average Cigarettes was associated with a 8.6% improvement in Anxiety—a modest effect. The Predictor Impact Score of 0.05 indicates this relationship is requiring additional data before conclusions.

Bottom Line: Based on a PIS of 0.05 and a 8.6% effect size, this relationship currently lacks sufficient evidence. Continue monitoring as more data becomes available. Note: These conclusions may strengthen or change direction as more data is collected.

These findings contribute to our understanding of how Cigarettes may influence Anxiety in real-world conditions. While preliminary, these results may inform future research directions. As more participants contribute data, the reliability and precision of these findings will improve substantially.

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Methods

Study Design

This study is based on data donated by 5 participants. Thus, the study design is equivalent to the aggregation of 5 separate n=1 observational natural experiments.

This within-subject design is powerful because it controls for all stable individual characteristics (genetics, baseline health status, socioeconomic factors) that might otherwise confound the relationship between variables.

Data Analysis

Temporal Assumptions

The analysis incorporates temporal assumptions about the relationship between variables:

  • Onset Delay: It was assumed that 30 minutes would pass before a change in Cigarettes would produce an observable change in Anxiety.
  • Duration of Action: It was assumed that Cigarettes could produce an observable change in Anxiety for as much as 21 days after the stimulus event.

Statistical Methods

For each participant, we calculated the Pearson correlation coefficient between Cigarettes values and subsequent Anxiety values. Individual correlations were then aggregated using Fisher's z-transformation to produce a population-level estimate:

Individual Correlation:

$$r_i = \frac{\sum(x_{ij} - \bar{x}_i)(y_{ij} - \bar{y}_i)}{\sqrt{\sum(x_{ij} - \bar{x}_i)^2 \sum(y_{ij} - \bar{y}_i)^2}}$$

Fisher's Z-Transformation:

$$z_i = \frac{1}{2} \ln\left(\frac{1 + r_i}{1 - r_i}\right)$$

Aggregated Correlation:

$$\bar{r} = \tanh(\bar{z}) \quad \text{where} \quad \bar{z} = \frac{1}{N}\sum_{i=1}^{N} z_i$$

Effect Size Calculation

Effect sizes are reported as percent change from baseline. For each participant, we compare the outcome following above-average predictor values to the overall baseline outcome:

$$\Delta\%_{\text{baseline}} = \frac{\bar{O}_{\text{follow-up}} - \bar{O}_{\text{baseline}}}{\bar{O}_{\text{baseline}}} \times 100$$

Effect Magnitude (Z-Score)

To assess effect magnitude relative to natural variability, we calculate the z-score:

$$z = \frac{|\Delta\%_{\text{baseline}}|}{\text{RSD}_{\text{baseline}}}$$

where RSDbaseline is the relative standard deviation of outcome during baseline period

A z-score > 2 indicates statistical significance (p < 0.05), meaning the observed change exceeds typical baseline fluctuation and is unlikely due to random variation.

Statistical Significance

Correlation significance is assessed using a two-tailed t-test:

$$t = \frac{r\sqrt{n-2}}{\sqrt{1-r^2}}$$

We reject the null hypothesis (ρ = 0) at α = 0.05 when |t| exceeds the critical value, providing statistical evidence that the observed relationship is not due to chance.

Data Sources

Cigarettes data was primarily collected using QuantiModo. QuantiModo allows you to easily track mood, symptoms, or any outcome you want to optimize in a fraction of a second. You can also import your data from over 30 other apps and devices. QuantiModo then analyzes your data to identify which hidden factors are most likely to be influencing your mood or symptoms.

Anxiety data was primarily collected using QuantiModo. QuantiModo allows you to easily track mood, symptoms, or any outcome you want to optimize in a fraction of a second. You can also import your data from over 30 other apps and devices. QuantiModo then analyzes your data to identify which hidden factors are most likely to be influencing your mood or symptoms.

Data Quality

Data quality measures were applied to ensure reliable results:

  • Minimum Data Requirement: Only participants with sufficient paired observations were included in the analysis.
  • Outlier Handling: Extreme values were winsorized to reduce the influence of measurement errors.
  • Missing Data: Days with missing values were handled using appropriate filling strategies based on the variable type.
  • Test User Exclusion: Test accounts and invalid users were excluded from all analyses.

Principal Investigator

Program & Methods

Mike P. Sinn
Sinn, M. P.

Designed and implemented data collection, aggregation, causal inference pipeline, and automated study generation framework. Developed the Predictor Impact Score methodology operationalizing Bradford Hill criteria for ranking causal relationships in observational data. When he tells people this at parties, they usually say they have to go check on their car.

Individual study outputs are automated, reproducible, and open to external audit. (Which I would seriously recommend.)

Contact

Cite This Study

APA Format
Sinn, M. P. (2026). Causal Analysis: Does Cigarettes (count) Affect Anxiety?. The Journal of Citizen Science. https://studies.crowdsourcingcures.org/study/cause-1634381-effect-5903391-population-study
BibTeX 
@misc{sinn_cause_1634381_effect_5903391_population_study_2026,
  author = {Sinn, Mike P.},
  title = {Causal Analysis: Does Cigarettes (count) Affect Anxiety?},
  year = {2026},
  publisher = {The Journal of Citizen Science},
  url = {https://studies.crowdsourcingcures.org/study/cause-1634381-effect-5903391-population-study},
  note = {Accessed: January 10, 2026}
}
Chicago/Turabian
Sinn, Mike P. "Causal Analysis: Does Cigarettes (count) Affect Anxiety?." The Journal of Citizen Science. Accessed January 10, 2026. https://studies.crowdsourcingcures.org/study/cause-1634381-effect-5903391-population-study.
Harvard
Sinn, M.P., 2026. Causal Analysis: Does Cigarettes (count) Affect Anxiety?. [Aggregated N-of-1 Study] The Journal of Citizen Science. Available at: https://studies.crowdsourcingcures.org/study/cause-1634381-effect-5903391-population-study [Accessed January 10, 2026].

Study Type: Aggregated N-of-1 Observational Mega-Study
Evidence Level: Level II (Real-World Evidence)
Methodology: Bradford Hill Criteria with Predictor Impact Score (PIS)

References

This framework was originally developed in 2013 based on the Bradford Hill criteria. Subsequent literature has independently validated similar approaches to causal inference from observational data:

  1. Hill, A.B. (1965). The environment and disease: association or causation? Proceedings of the Royal Society of Medicine, 58(5), 295-300. [Bradford Hill criteria]
  2. Lillie, E.O., et al. (2011). The n-of-1 clinical trial: the ultimate strategy for individualizing medicine? Personalized Medicine, 8(2), 161-173. [N-of-1 methodology]
  3. Pearl, J. (2009). Causality: Models, Reasoning, and Inference . Cambridge University Press. [Causal inference]
  4. Hernán, M.A., & Robins, J.M. (2020). Causal Inference: What If . Chapman & Hall/CRC. [Free textbook]
  5. FDA (2018). Framework for FDA's Real-World Evidence Program . U.S. Food and Drug Administration. [Regulatory context]
  6. Duan, N., et al. (2013). Single-patient (n-of-1) trials: a pragmatic clinical decision methodology . Journal of Clinical Epidemiology, 66(8), S21-S28.
  7. Platt, R., et al. (2018). The FDA Sentinel Initiative—an evolving national resource . New England Journal of Medicine, 379(22), 2091-2093.

This information is for research and educational purposes only, not medical advice. Consult a healthcare provider before making health decisions. Terms of Service

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