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Tobacco smoking is associated with psychotic experiences in the general population of South London

Published online by Cambridge University Press:  28 June 2017

V. Bhavsar ,
S. Jauhar ,
R. M. Murray ,
M. Hotopf ,
S. L. Hatch ,
A. McNeill ,
J. Boydell  and
J. H. MacCabe
V. Bhavsar*
Affiliation:
Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London
S. Jauhar
Affiliation:
Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London
R. M. Murray
Affiliation:
Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London
M. Hotopf
Affiliation:
Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London South London and Maudsley NHS Foundation Trust, London
S. L. Hatch
Affiliation:
Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London
A. McNeill
Affiliation:
National Addictions Centre, Institute of Psychiatry, Psychology and Neuroscience and UK Centre for Tobacco and Alcohol Studies, King's College London, London
J. Boydell
Affiliation:
Cornwall Partnership Foundation NHS Trust, Cornwall
J. H. MacCabe
Affiliation:
Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London South London and Maudsley NHS Foundation Trust, London
*
*Address for correspondence: V. Bhavsar, Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London. (Email: vishal.2.bhavsar@kcl.ac.uk)
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Abstract

Background

The association between cigarette smoking and psychosis remains unexplained, but could relate to causal effects in both directions, confounding by socioeconomic factors, such as ethnicity, or use of other substances, including cannabis. Few studies have evaluated the association between cigarettes and psychotic experiences (PEs) in diverse, inner-city populations, or relationships with number of cigarettes consumed.

Methods

We assessed associations and dose–response relationships between cigarette smoking and PEs in a cross-sectional survey of household residents (n = 1680) in South East London, using logistic regression to adjust for cannabis use, other illicit substances, and socioeconomic factors, including ethnicity.

Results

We found association between any PEs and daily cigarette smoking, which remained following adjustment for age, gender, ethnicity, cannabis and use of illicit stimulant drugs (fully adjusted odds ratio 1.47, 95% confidence interval 1.01–2.15). Fully adjusted estimates for the association, and with number of PEs, increased with number of cigarettes smoked daily, implying a dose–response effect (p = 0.001 and <0.001, respectively). Odds of reporting any PEs in ex-smokers were similar to never-smokers.

Conclusions

In this diverse epidemiological sample, association between smoking and PEs was not explained by confounders such as cannabis or illicit drugs. Daily cigarette consumption showed a dose–response relationship with the odds of reporting PEs, and of reporting a greater number of PEs. There was no difference in odds of reporting PEs between ex-smokers and never-smokers, raising the possibility that the increase in PEs associated with smoking may be reversible.

Keywords

Confoundingepidemiologyethnicitypsychosistobacco smoking
Type
Original Articles
Information
Psychological Medicine , Volume 48 , Issue 1 , January 2018 , pp. 123 - 131
Copyright
Copyright © Cambridge University Press 2017 

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