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For MVMR, in addition to the multivariable extension of the MR PRESSO global test, we used the multivariable extension of the MR Lasso method, which applies lasso-type penalization to the direct effects of the instruments on the outcome disease: the so-called post-lasso estimate is obtained by performing MR IVW using only those instruments identified as valid instruments (tuning parameter specified at default heterogeneity stopping rule) 89

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Smoking-related diseases are the leading cause of death in this population, and Black Americans who smoke are more likely to die of smoking-related causes than their white counterparts