Tobacco smoking behaviors in bipolar disorder: a comparison of the general population, schizophrenia, and major depression
Abstract
OBJECTIVES: This study compared the prevalence of tobacco smoking behaviors in patients with bipolar disorder with normal and psychiatric (schizophrenia and major depression) controls. The main goal was to establish that bipolar patients smoke more than normal controls. Differences with psychiatric controls were explored. METHODS: Samples of 424 patients (99 bipolar, 258 schizophrenia and 67 major depression) and 402 volunteer controls were collected in Central Kentucky. Smoking data for Kentucky's general population were available. Odds ratios (ORs) and their 95% confidence intervals (CIs) were used to establish the strength of associations. Logistic regression was used to adjust ORs for confounding variables. RESULTS: Using epidemiological definitions of smoking behaviors and the general population as controls provided bipolar disorder unadjusted ORs of 5.0 (95% CI: 3.3-7.8) for current cigarette smoking, 2.6 (95% CI: 1.7-4.4) for ever cigarette smoking, and 0.13 (95% CI: 0.03-0.24) for smoking cessation. Using a clinical definition and volunteers as controls provided respective bipolar disorder adjusted ORs of 7.3 (95% CI: 4.3-12.4), 4.0 (95% CI: 2.4-6.7), and 0.15 (95% CI: 0.06-0.36). Prevalences of current daily smoking for patients with major depression, bipolar disorder, and schizophrenia were 57%, 66%, and 74%, respectively. CONCLUSIONS: Bipolar disorder was associated with significantly higher prevalences of tobacco smoking behaviors compared with the general population or volunteer controls, independently of the definition used. It is possible that smoking behaviors in bipolar disorder may have intermediate prevalences between major depression and schizophrenia, but larger samples or a combination of multiple studies (meta-analysis) will be needed to establish whether this hypothesis is correct.
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The prevalence of everyday current smoking is 66% in people with bipolar disorder in a Kentucky catchment area study, significantly elevated compared to the general population and exceeding rates in major depression and schizophrenia.
“A catchment area study from Kentucky reports that the prevalence of everyday current smoking is 66% in people with BD, which is also significantly elevated when compared to the general population, and also exceeds the rate observed in people with major depression and schizophrenia (9).”
From The detrimental effects of smoking on the course and outcome in adults with bipolar disorder—A narrative review (2023) · cites this paper as [9]
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“Thus, smoking must be taken into account in any study that evaluates the effect of BD on HRV because a substantial proportion of BD patients smoke or have a history of smoking.(32) The second main finding of this study was that the BD patients are expected to be associated with lower parasympathetic activity, higher s…”
BackgroundSmoking outcome by psychiatric history after behavioral and varenicline treatment
McClure, J. B., Swan, G. E., Catz, S. L., Jack, L. M., Javitz, H. S., McAfee, T. A., Deprey, M., Richards, J. A., & Zbikowski, S. M. (2010) · Journal of Substance Abuse Treatment · doi:10.1016/j.jsat.2010.03.007 · Cited by 47 · see citing works
“Introduction Rates of tobacco use and dependence are disproportionately high among those with psychiatric disorders (Diaz et al., 2009; Gonzalez-Pinto et al., 1998; Lasser et al., 2000; Ziedonis, Hitsman, Beckham, Zvolensky, Adler, Adurain-McGovern et al., 2008).”
BackgroundJohnson, J. L., Ratner, P. A., Malchy, L. A., Okoli, C. T. C., Procyshyn, R. M., Bottorff, J. L., Groening, M., Schultz, A. S. H., & Osborne, M. (2010) · BMC Psychiatry · doi:10.1186/1471-244x-10-101 · Cited by 46 · see citing works
“It has been reported that, in Kentucky, the prevalence of current daily smoking for patients with bipolar disorder and schizophrenia were 66% and 74%, respectively [31].”
Ren, W., Gu, Y., Zhu, L., Wang, L., Chang, Y., Yan, M., Han, B., & He, J. (2015) · Comprehensive Psychiatry · doi:10.1016/j.comppsych.2015.09.006 · Cited by 45 · see citing works
“Previous studies have demonstrated that smoking is associated with an increased risk of depression, suicide, and other mental illnesses [5–11].”
BackgroundSleep apnea risk and clinical correlates in patients with bipolar disorder
Soreca, I., Levenson, J. C., Lotz, M., Frank, E., & Kupfer, D. J. (2012) · Bipolar Disorders · doi:10.1111/j.1399-5618.2012.01044.x · Cited by 43 · see citing works
Psychological Co-morbidities of Physical Illness
Pagoto, S. (2011) · Springer eBooks · doi:10.1007/978-1-4419-0029-6 · Cited by 42 · see citing works
Steinberg, M. L., Williams, J. M., Stahl, N. F., Budsock, P. D., & Cooperman, N. A. (2015) · Nicotine & Tobacco Research · doi:10.1093/ntr/ntv043 · Cited by 41 · see citing works
“randomization program with “urns” for (1) Sex, (2) Diagnosis, and (3) Motivation to Quit (Low [0–2], Medium [3–7], or High [8–10] based on a 1–10 scale response to the statement “I am going to quit smoking”).”
BackgroundVariants in the 15q25 gene cluster are associated with risk for schizophrenia and bipolar disorder
Jackson, K. J., Fanous, A. H., Chen, J., Kendler, K. S., & Chen, X. (2012) · Psychiatric Genetics · doi:10.1097/ypg.0b013e32835bd5f1 · Cited by 40 · see citing works
“…relationship between smoking and bipolar disorder, the prevalence of smoking in bipolar disorder, though not as high as schizophrenia, has been reported between 66 and 69% (Lasser et al., 2000; Vanable et al., 2003; Diaz et al., 2009), approximately twice that of the general population (20–30%).”
BackgroundImaging synaptic density in depression
Holmes, S. E., Abdallah, C., & Esterlis, I. (2023) · Neuropsychopharmacology · doi:10.1038/s41386-022-01368-4 · Cited by 39 · see citing works
“, higher rates of suicidality than the general population [2], higher rates of unemployment, and higher rates of comorbid substance use [3]] and can be treatment refractory.”
Backgroundde León, J., & DÍAZ, F. J. (2011) · Human Genetics · doi:10.1007/s00439-011-1122-6 · Cited by 39 · see citing works
“A prior article described the diVerences and overlap between these two deWnitions (Diaz et al. 2009) a For data from the general population, the population attributable risk was computed as (P/100) £ (OR ¡ 1)/{(P/100) £ (OR ¡ 1) + 1} (Bolton and Robinson 2010)”
InfluentialThe role of BDNF genetic polymorphisms in bipolar disorder with psychiatric comorbidities
Neves, F. S., Malloy‐Diniz, L. F., Romano‐Silva, M. A., Campos, S. B., de Miranda, D. M., Marco, L. A. D., Figueira, P. G., Krebs, M., & Corrêa, H. (2010) · Journal of Affective Disorders · doi:10.1016/j.jad.2010.11.022 · Cited by 37 · see citing works
“Nevertheless in view of the higher smoking prevalence in BD as compared with the general population (Diaz et al., 2009), the association between smoking and suicidal behavior (Ostacher et al., 2009; Neves and Correa, 2007) as well with a worse outcome in BD (Ostacher et al., 2006) we thought it…”
BackgroundGenetic overlap and causal associations between smoking behaviours and mental health
Barkhuizen, W., Dudbridge, F., & Ronald, A. (2021) · Scientific Reports · doi:10.1038/s41598-021-93962-7 · Cited by 38 · see citing works
Rombaldi, A. J., da Silva, M. C., Gazalle, F. K., Azevedo, M. R., & Hallal, P. C. (2010) · Revista Brasileira de Epidemiologia · doi:10.1590/s1415-790x2010000400007 · Cited by 32 · see citing works
Zeng, L., Zong, Q.-Q., Zhang, L., Feng, Y., Ng, C. H., Ungvari, G. S., Chen, L.-G., & Xiang, Y. (2020) · Asian Journal of Psychiatry · doi:10.1016/j.ajp.2020.102190 · Cited by 36 · see citing works
Heffner, J. L., DelBello, M. P., Anthenelli, R. M., Fleck, D. E., Adler, C. M., & Strakowski, S. M. (2012) · Bipolar Disorders · doi:10.1111/j.1399-5618.2012.00985.x · Cited by 36 · see citing works
“18) on mean change in symptoms of mania [F(1,46) = 2.”
InfluentialHirasawa-Fujita, M., Bly, M. J., Ellingrod, V. L., Dalack, G. W., & Domino, E. F. (2017) · Clinical Schizophrenia & Related Psychoses · doi:10.3371/1935-1232-11.1.39 · Cited by 35 · see citing works
Relationship between olfactory function and social cognition in euthymic bipolar patients
Lahera, G., Ruiz-Murugarren, S., Fernández-Liria, A., Saiz-Ruiz, J., Buck, B. E., & Penn, D. L. (2016) · CNS Spectrums · doi:10.1017/s1092852913000382 · Cited by 34 · see citing works
Xu, Y., Chen, H., Li, F., Deng, F., Liu, X.-B., Yang, H., Qi, L.-G., Jin-hong, G., & Liu, T. (2014) · PLoS ONE · doi:10.1371/journal.pone.0088478 · Cited by 34 · see citing works
“Third, the definition of smoking used in the present study is broader, because it defines a current smoker as an ever smoker who currently smokes daily or on some days [81].”
BackgroundEmotional and affective temperaments and cigarette smoking in a large sample
Bisol, L. W., Soldado, F. A., Albuquerque, C., Lorenzi, T. M., & Lara, D. R. (2010) · Journal of Affective Disorders · doi:10.1016/j.jad.2010.04.016 · Cited by 30 · see citing works
“bipolar disorder is higher than general population and close to the prevalence in schizophrenia (Döme et al., 2005; Diaz et al., 2009).”
BackgroundLithium use and risk of fracture: a systematic review and meta-analysis of observational studies
Liu, B., Wu, Q. F., Zhang, S., & Rosario, A. D. (2018) · Osteoporosis International · doi:10.1007/s00198-018-4745-9 · Cited by 30 · see citing works
Lagerberg, T. V., Icick, R., Andreassen, O. A., Ringen, P. A., Étain, B., Aas, M., Henry, C., Bjella, T. D., Melle, I. S., & Bellivier, F. (2015) · Journal of Affective Disorders · doi:10.1016/j.jad.2015.10.023 · Cited by 30 · see citing works
Caponnetto, P., DiPiazza, J., Kim, J. J., Maglia, M. G., & Polosa, R. (2021) · Nicotine & Tobacco Research · doi:10.1093/ntr/ntab005 · Cited by 28 · see citing works
“Subjective effects were assessed by Modified Cigarette Evaluation Questionnaire (mCEQ) scoring that reported frequency and percent of participants reporting (1) enjoyment of respiratory tract sensations, (2) psychological reward, and (3) satisfaction, among users of e-cigarettes.”
A Review of Impact of Tobacco Use on Patients with Co-occurring Psychiatric Disorders
Pal, A., & Balhara, Y. P. S. (2016) · Tobacco Use Insights · doi:10.4137/tui.s32201 · Cited by 28 · see citing works
Caldirola, D., Daccò, S., Grassi, M., Citterio, A., Menotti, R., Cavedini, P., Girardi, P., & Perna, G. (2013) · The Journal of Clinical Psychiatry · doi:10.4088/jcp.12m07985 · Cited by 27 · see citing works
Age-related changes in physiology in individuals with bipolar disorder
Mutz, J., Young, A. H., & Lewis, C. M. (2021) · Journal of Affective Disorders · doi:10.1016/j.jad.2021.09.027 · Cited by 27 · see citing works
Psychological Issues in Adults with Type 2 Diabetes
Gonzalez, J. S., Esbitt, S. A., Schneider, H. E., Osborne, P. J., & Kupperman, E. (2011) · Springer eBooks · doi:10.1007/978-1-4419-0029-6_2 · Cited by 27 · see citing works
“Individuals with serious mental illnesses such as bipolar disorder or psychotic disorders also have higher rates of tobacco usage than the general population (Diaz et al., 2009; Diwan, Castine, Pomerleau, Meador-Woodruff, & Dalack, 1998).”
BackgroundPratt, S. I., Ferron, J. C., Brunette, M. F., Santos, M. M., Sargent, J. D., & Xie, H. (2022) · Nicotine & Tobacco Research · doi:10.1093/ntr/ntac082 · Cited by 25 · see citing works
Weighing the Risks: the Management of Bipolar Disorder During Pregnancy
Thomson, M., & Sharma, V. (2018) · Current Psychiatry Reports · doi:10.1007/s11920-018-0882-2 · Cited by 24 · see citing works
Heffner, J. L., Evins, A. E., Russ, C., Lawrence, D., Ayers, C. R., McRae, T., Aubin, L. S., Krishen, A., West, R., & Anthenelli, R. M. (2019) · Journal of Affective Disorders · doi:10.1016/j.jad.2019.06.008 · Cited by 23 · see citing works
“, 2000) and, among the major psychiatric disorders, is second only to schizophrenia (Diaz et al., 2009; Dickerson et al., 2013).”
BackgroundNovak, G., Zai, C. C., Mirkhani, M., Shaikh, S., Vincent, J. B., Meltzer, H., Lieberman, J. A., Strauss, J., Lévesque, D., Kennedy, J. L., et al. (2010) · Genes, Brain and Behavior · doi:10.1111/j.1601-183x.2010.00631.x · Cited by 23 · see citing works
“1986) and bipolar disorder (Diaz et al. 2009), contributing additional morbidity to an already susceptible population.”
BackgroundSpivak, S., Mojtabai, R., Green, C., Firth, T., Sater, H., & Cullen, B. (2019) · Psychiatric Services · doi:10.1176/appi.ps.201700561 · Cited by 23 · see citing works
Caponnetto, P., Polosa, R., Robson, D., & Bauld, L. (2020) · Health Psychology Research · doi:10.4081/hpr.2020.9042 · Cited by 24 · see citing works
Romain, A., Bernard, P., Akrass, Z., St-Amour, S., Lachance, J.-P., Hains-Monfette, G., Atoui, S., Kingsbury, C., Dubois, E., Karelis, A., et al. (2020) · Schizophrenia Research · doi:10.1016/j.schres.2020.05.049 · Cited by 19 · see citing works
Heffner, J. L., Anthenelli, R. M., Adler, C. M., Strakowski, S. M., Beavers, J., & DelBello, M. P. (2013) · Psychiatry Research · doi:10.1016/j.psychres.2013.04.010 · Cited by 22 · see citing works
Maternal smoking during pregnancy and risks of suicidal acts in young offspring
Cnattingius, S., Svensson, T., Granath, F. N., & Iliadou, A. N. (2011) · European Journal of Epidemiology · doi:10.1007/s10654-011-9556-7 · Cited by 22 · see citing works
“Both smoking and suicidal acts are associated with family dysfunction, other life-style habits, psychological problems and psychiatric diseases not requiring in-patient care [3, 14, 29, 30].”
BackgroundNicotine intake and smoking topography in smokers with bipolar disorder
Williams, J. M., Gandhi, K. K., Lu, S., Steinberg, M. L., & Benowitz, N. L. (2012) · Bipolar Disorders · doi:10.1111/j.1399-5618.2012.01047.x · Cited by 21 · see citing works
“Cigarette smoking is common in BPD, with prevalence rates of about 60% in various studies (1, 4), and heavy smoking has also been found to be common in patients with this condition (10).”
BackgroundA Review of Smoking Cessation in Bipolar Disorder: Implications for Future Research
George, T. P., Wu, B. S., & Weinberger, A. H. (2012) · Journal of Dual Diagnosis · doi:10.1080/15504263.2012.671717 · Cited by 21 · see citing works
“7]) for ever smoking, compared to controls (Diaz et al., 2009).”
BackgroundElevated Familial Cardiovascular Burden Among Adolescents With Familial Bipolar Disorder
Toma, S., Fıksenbaum, L., Omrin, D. S., & Goldstein, B. I. (2019) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2019.00008 · Cited by 20 · see citing works
Birner, A., Seiler, S., Lackner, N., Bengesser, S., Queissner, R., Fellendorf, F. T., Platzer, M., Ropele, S., Enzinger, C., Schwingenschuh, P., et al. (2015) · PLoS ONE · doi:10.1371/journal.pone.0135313 · Cited by 19 · see citing works
“Additionally, smoking behavior and obesity/metabolic syndrome differentially affect individuals with BD [20, 21].”
BackgroundMartínez-Ortega, J. M., Jurado, D., & Manuel Gurpegui, A. (2008) · Progress in Neuro-Psychopharmacology and Biological Psychiatry · doi:10.1016/j.pnpbp.2008.09.015 · Cited by 19 · see citing works
Das, S., Tonelli, M. E., & Ziedonis, D. M. (2016) · Current Psychiatry Reports · doi:10.1007/s11920-016-0681-6 · Cited by 18 · see citing works
Martínez-Ortega, J. M., Goldstein, B. I., Gutiérrez-Rojas, L., Sala, R., Wang, S., & Blanco, C. (2013) · Journal of Psychiatric Research · doi:10.1016/j.jpsychires.2013.03.012 · Cited by 17 · see citing works
“In particular, individuals with bipolar disorder (BD) as compared to the general population are more likely to have a lifetime history of smoking (Diaz et al., 2009; Gonzalez-Pinto et al., 1998; Lasser et al., 2000), current smoking (Diaz et al.”
BackgroundInfluentialOkoli, C. T. C., Otachi, J. K., Kaewbua, S., Woods, M. A., & Robertson, H. E. (2017) · Journal of the American Psychiatric Nurses Association · doi:10.1177/1078390317704045 · Cited by 17 · see citing works
“Moreover, in 2009, rates of smoking among hospitalized patients with MI in Kentucky were as high as 74% for individuals with schizophrenia as compared to 31% in the state (Diaz et al., 2009).”
Kluge, M., Hegerl, U., Sander, C., Dietzel, J., Mergl, R., Bitter, I., Demyttenaere, K., Gusmão, R. M., González-Pinto, A. M., Pérez, V., et al. (2013) · BMC Psychiatry · doi:10.1186/1471-244x-13-71 · Cited by 16 · see citing works
“Withdrawal of vigilance-stabilising drugs, such as nicotine, can trigger mania [17,18] and a high smoking prevalence has been reported in bipolar disorder [19].”
BackgroundOne size doesn’t fit all: A trial of individually tailored skills training.
Pratt, S. I., Mueser, K. T., Wolfe, R. S., Santos, M. M., & Bartels, S. J. (2017) · Psychiatric Rehabilitation Journal · doi:10.1037/prj0000261 · Cited by 17 · see citing works
“This early mortality disparity reflects a variety of preventable health conditions including greater rates of obesity and tobacco use (Daumit et al., 2003; Diaz et al., 2009; Dickerson et al., 2006; Lasser et al., 2000), as well as poor access to primary health care (Druss, Bradford, Rosenheck, Radford, & Krumholz, 20…”
BackgroundJaén‐Moreno, M. J., Feu, N., del Pozo, G. I., Gómez, C., Carrión, L., Chauca, G. M. C., Guler, I., Montiel, F. J., Sánchez, M. D., Alcalá, J. A., et al. (2021) · European Psychiatry · doi:10.1192/j.eurpsy.2021.12 · Cited by 16 · see citing works
Assessing treatment response to prophylactic lithium use in patients with bipolar disorder
Silva, L. F. D. A. L. E., Loureiro, J. C., Franco, S. C. R., Santos, M. D. L., Secolin, R., Lopes‐Cendes, Í., Dantas, C. D. R., & Banzato, C. E. M. (2016) · Jornal Brasileiro de Psiquiatria · doi:10.1590/0047-2085000000097 · Cited by 14 · see citing works
Healthy lifestyle intervention for people with severe mental disorders
Baker, A., KAY‐LAMBKIN, F. J., RICHMOND, R. L., Filia, S., Castle, D. J., Williams, J. M., & Thornton, L. K. (2011) · Mental Health and Substance Use · doi:10.1080/17523281.2011.555086 · Cited by 14 · see citing works
“The majority of people with schizophrenia and bipolar disorder smoke (Diaz et al., 2009), thereby increasing their risk of CVD.”
BackgroundChen, P., Chang, C.-K., Chiang, S.-J., Lin, Y., Tsai, S., & Huang, S. (2017) · Psychiatry Research · doi:10.1016/j.psychres.2017.01.004 · Cited by 13 · see citing works
Treating Smoking in Adults With Co-occurring Acute Psychiatric and Addictive Disorders
Das, S., Hickman, N. J., III, & Prochaska, J. J. (2017) · Journal of Addiction Medicine · doi:10.1097/adm.0000000000000320 · Cited by 13 · see citing works
“In treatment settings, over half of patients smoke; methadone maintenance programs and inpatient psychiatry units generally have the highest rates, in the range of 75% to 95% (Kleber et al., 2007; Diaz et al., 2009).”
Smoking is Associated with Greater Symptom Load in Bipolar Disorder Patients
Saiyad, M., & El-Mallakh, R. S. (2012) · Annals of Clinical Psychiatry · doi:10.1177/104012371202400409 · Cited by 13 · see citing works
Okoli, C. T. C., Otachi, J. K., Manuel, A., & Woods, M. A. (2017) · Journal of Psychiatric and Mental Health Nursing · doi:10.1111/jpm.12435 · Cited by 13 · see citing works
Robson, D., Cole, F., Jalasi, S., Boojharut, B., Smith, S. M. R., Thompson, S., Jones, M., & Haddad, M. (2012) · Journal of Clinical Nursing · doi:10.1111/j.1365-2702.2012.04222.x · Cited by 12 · see citing works
“The prevalence of daily smoking for patients with major depression, bipolar disorder and schizophrenia is estimated to be 57, 66 and 74%, respectively (Diaz et al. 2009).”
BackgroundHirasawa-Fujita, M., Bly, M. J., Ellingrod, V. L., Dalack, G. W., & Domino, E. F. (2014) · Clinical Schizophrenia & Related Psychoses · doi:10.3371/csrp.mhmb.061314 · Cited by 12 · see citing works
The prevalence and associated clinical correlates of hyperuricemia in patients with bipolar disorder
Li, S., Lu, X., Chen, X., Huang, Z., Zhou, H., Li, Z., & Ning, Y. (2022) · Frontiers in Neuroscience · doi:10.3389/fnins.2022.998747 · Cited by 12 · see citing works
“According to previous studies, BPD patients have higher rates of smoking (Diaz et al., 2009) and drinking habits (Liberopoulos et al.”
MethodNishiyama, M., Kimijima, M., Muto, T., & Kimura, K. (2011) · Environmental Health and Preventive Medicine · doi:10.1007/s12199-011-0250-x · Cited by 12 · see citing works
“In studies investigating lifestyle among psychiatric inpatients and outpatients [15, 16], alcohol consumption and unhealthy dietary habits were suggested to be risk factors for depression [15], and a diagnosis of bipolar disorder was found to be independently related to smoking status [15, 17, 18] and being overweight…”
BackgroundEffects of smoking on health outcomes in bipolar disorder with a special focus on suicidal behavior
Döme, P., Gonda, X., & Rihmer, Z. (2012) · Neuropsychiatry · doi:10.2217/npy.12.51 · Cited by 11 · see citing works
Is Mania the Hypertension of the Mood? Discussion of A Hypothesis
Rihmer, Z., Gonda, X., & Döme, P. (2017) · Current Neuropharmacology · doi:10.2174/1570159x14666160902145635 · Cited by 11 · see citing works
“d) Prevalence of smoking is also markedly increased both in bipolar patients [134, 135] and in hypertension [136].”
Background
- Authors
- Diaz, F. J., James, D., Botts, S., Maw, L., Susce, M. T., & De Leon, J.
- Affiliations
- University of Kentucky (US)
- ORCID
- Botts, Sheila
- Venue
- Bipolar Disorders
- Publisher
- Wiley
- Published
- 2009-02-25
- Volume
- 11
- Issue
- 2
- Pages
- 154-165
- ISSN
- 1398-5647 (ISSN-L)
- 1399-5618
- OpenAlex
- W1979173012
- Cited by
- 179
- References
- 49
- Citations by year
- 2026: 6 · 2025: 2 · 2024: 2 · 2023: 5 · 2022: 12 · 2021: 6 · 2020: 10 · 2019: 8 · 2018: 6 · 2017: 12 · 2016: 6 · 2015: 20 · 2014: 6 · 2013: 12 · 2012: 24
- FWCI
- 14.36
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Bipolar Disorders (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Physiology › Smoking Behavior and Cessation
- Health Sciences › Medicine › Psychiatry and Mental health › Bipolar Disorder and Treatment
- Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
- Keywords
- smoking, bipolar disorder, schizophrenia, major depressive disorder, smoking prevalence, smoking cessation, psychiatric comorbidity
- MeSH terms
- Adult, Bipolar Disorder, Major Depressive Disorder, Female, Humans, Male, Middle Aged, Schizophrenia, Schizophrenic Psychology, Smoking, Prevalence, Confidence Intervals, Odds Ratio, Population Groups
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