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Cigarette smoking and mortality risk in people with schizophrenia

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Kelly, D. L., McMahon, R. P., Wehring, H. J., Liu, F., Mackowick, K. M., Boggs, D. L., Warren, K. R., Feldman, S. +3 more·2011·Schizophrenia Bulletin
DOI 10.1093/schbul/sbp152PMC PMC3122289
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Abstract

This study examined effects of cigarette smoking on mortality risk in 1213 persons aged 19-69 years with schizophrenia-related psychotic disorders admitted to State of Maryland Hospitals between 1994 and 2000. Inpatient medical records from 7 hospitals were reviewed to obtain demographic information, diagnosis, medication use, as well as smoking and other substance use. Social Security Death Index data were used to identify deaths in the study group between 1994 and 2004. Death records were reviewed to obtain manner of death and underlying disorders. Of the 1213, 55% were smokers and 71% abused substances. There was an age × smoking interaction (χ(2) = 14.6, df = 1, P = .0001) for mortality, with estimated hazard ratios (HRs) for smokers vs nonsmokers of 2.1 among 35- to 54-year olds and HR of 0.7 among those aged 55-69 years. Five- and 10-year mortality rates for smokers aged 35-54 years were 7.0% and 14.2%, compared with 3.3% and 10.0% for nonsmokers, respectively (χ(2) = 5.53, df = 1, P = .019). Cardiac causes were identified in 43% of deaths in smokers but only 19% of deaths in nonsmokers (P < .006). For those aged 35-54 years, the odds of cardiac related death was increased by 12 fold in smokers relative to nonsmokers (HR = 12.4, χ(2) = 12.0, df = 1, P = .0005). Among people aged 35-54 years, those smoking greater than one pack daily have a significantly increased total mortality risk (HR = 2.7) vs nonsmokers. Cigarette smoking, particularly in people aged 35-54 years, contributes to an increased risk of death. Greater smoking severity significantly increases this risk. Smoking cessation in people with schizophrenia deserves significant attention.

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  • There was no difference in mortality risk between BME and white British groups beyond what would be expected by chance.

    “Although mortality risk was slightly lower in cases from the BME compared with the white British group, in contrast to earlier research,23,24 we found no difference beyond what would be expected by chance.”

    From Mortality in Schizophrenia and Other Psychoses: A 10-Year Follow-up of the ӔSOP First-Episode Cohort (2015) · cites this paper as [24]

  • The absence of systematic differences across ethnic groups may be accounted for by social and health disparities in BME populations being offset through greater attention to medical treatment of physical health problems in patients in the care of mental health services.

    “the absence of systematic differences across ethnic groups or, as has been reported earlier, an even lower mortality risk in BME groups,23,24 may be accounted for by social and health disparities in BME populations being offset through the, relatively speaking, greater attention to medical treatment of physical health problems in patients in the care of mental health services.”

    From Mortality in Schizophrenia and Other Psychoses: A 10-Year Follow-up of the ӔSOP First-Episode Cohort (2015) · cites this paper as [24]

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  1. [15]15. and Support Service in Victoria. Aust N Z J Public Health . 2008;32:479-481.

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Authors
Kelly, D. L., McMahon, R. P., Wehring, H. J., Liu, F., Mackowick, K. M., Boggs, D. L., Warren, K. R., Feldman, S., Shim, J.-C., Love, R. C., & Dixon, L.
Affiliations
  • University of Maryland, Baltimore (US)
  • Inje University (KR)
ORCID
Venue
Schizophrenia Bulletin
Publisher
Oxford University Press (OUP)
Published
2009-12-17
Volume
37
Issue
4
Pages
832-838
ISSN
  • 0586-7614 (ISSN-L)
  • 1745-1701
DOI
10.1093/schbul/sbp152
PMC
PMC3122289
OpenAlex
W2140909692
Cited by
158
References
39
Citations by year
2026: 2 · 2025: 3 · 2024: 5 · 2023: 7 · 2022: 3 · 2021: 7 · 2020: 9 · 2019: 8 · 2018: 6 · 2017: 16 · 2016: 11 · 2015: 16 · 2014: 11 · 2013: 21 · 2012: 17
FWCI
7.09
Type
journal article
Language
en
Open access
Locations
  • Schizophrenia Bulletin (publishedVersion)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
Funders
  • National Institutes of Health (5p50mh040279-05)
  • National Institute of Mental Health (R03MH076985, P50 MH 40279)
Topics
  • Health Sciences › Medicine › Physiology › Smoking Behavior and Cessation
  • Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
  • Social Sciences › Psychology › Clinical Psychology › Suicide and Self-Harm Studies
Keywords
cigarette smoking, mortality risk
MeSH terms
Adult, Age Factors, Aged, Cause of Death, Coronary Disease, Female, Humans, Male, Maryland, Middle Aged, Regression Analysis, Risk, Schizophrenia, Smoking, Antipsychotic Agents, Comorbidity, Proportional Hazards Models, Odds Ratio, Substance-Related Disorders, Young Adult

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