Which principle states that association alone does not prove causation?

• A. Association does not imply causation
• B. Correlation proves causation
• C. Temporality is irrelevant
• D. Dose-response is not necessary to prove causation

Answer: (A)

Association does not prove causation means that just because two things occur together, one doesn’t automatically cause the other. An observed link can arise from confounding factors that influence both variables, biases in study design or measurement, or simply random chance. To move from association to causation, we look for evidence that the exposure came before the outcome (temporality), that greater exposure is linked to a stronger effect (dose‑response), and that findings are consistent across different studies and populations. Biological plausibility and coherence with what we know about biology also help, and experimental or intervention data can provide strong support. So the statement that correlation proves causation or that temporality is irrelevant would misstate how we establish causal relationships; dose‑response is a helpful, often supporting, piece of evidence but not the sole determinant.