Cited by 158Smoking Behavior and CessationSchizophrenia research and treatmentSubstance Abuse Treatment and Outcomes

Tobacco Use Before, At, and After First-Episode Psychosis: A Systematic Meta-Analysis

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Myles, Nicholas, Newall, Hannah D., Curtis, Jackie, Nielssen, Olav, Shiers, David, Large, Matthew·2012·The Journal of Clinical Psychiatry

Abstract

OBJECTIVE: Patients with first-episode psychosis have a high prevalence of tobacco use. We aimed to examine the prevalence and course of tobacco use during early psychosis using meta-analysis. DATA SOURCES: Systematic search of MEDLINE (1948-2011), Embase (1947-2011), CINAHL (1984-2011), PsycINFO (1967-2011), and ISI Web of Science (1900-2011) using the search terms [psychosis OR schizophrenia] AND [tobacco OR smoking OR nicotine]. STUDY SELECTION: We located 10 studies reporting the age at initiation of daily tobacco use and the age at onset of psychosis, 31 studies reporting prevalence of tobacco use in patients with first-episode psychosis, 10 studies comparing smoking to age-/gender-matched controls, and 7 studies reporting prevalence of tobacco use at intervals after treatment. DATA EXTRACTION: The following data were extracted: age at initiation of daily tobacco use and at onset of psychosis, the proportion of patients with first-episode psychosis who used tobacco, the proportion of the general population who used tobacco, and the proportion of patients with psychosis who used tobacco at various intervals after initiation of antipsychotic treatment. RESULTS: The pooled estimate for the interval between initiation of tobacco use and the onset of psychosis was 5.3 years (standardized mean difference = 0.85). The estimated prevalence of tobacco users in first episode of psychosis is 58.9% (95% CI, 54.3%-63.4%). There is a strong association between first-episode psychosis and tobacco use (OR = 6.04; 95% CI, 3.03-12.02) compared with healthy controls. The prevalence of tobacco use at intervals between 6 and 120 months after treatment remained unchanged (OR = 0.996; 95% CI, 0.907-1.094). CONCLUSIONS: Patients with first-episode psychosis tend to have smoked for some years prior to the onset of psychosis, have high prevalence of tobacco use at the time of presenting for treatment, and are much more likely to smoke than aged-matched controls. Their apparent difficulty in quitting has implications for tobacco cessation programs and efforts to reduce cardiovascular disease among people with mental illness.

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  1. Wade D, Harrigan S, Edwards J, et al. Course of substance misuse and See supplementary material for this article at . For the CME Posttest for this article, see pages 476-477. daily tobacco use in first-episode psychosis. Schizophr Res. 2006;81(2-3): 145-150. d o i : 1 0 . 1 0 1 6 / j . s c h r e s . 2 0 0 5 . 0 9 . 0 1
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  3. © COPYRIGHT 2012 PHYSICIANS POSTGRADUATE PRESS, INC. © COPYRIGHT 2012 PHYSICIANS POSTGRADUATE PRESS, INC.
  4. © COPYRIGHT 2012 PHYSICIANS POSTGRADUATE PRESS, INC. © COPYRIGHT 2012 PHYSICIANS POSTGRADUATE PRESS, INC.
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  7. © COPYRIGHT 2012 PHYSICIANS POSTGRADUATE PRESS, INC. © COPYRIGHT 2012 PHYSICIANS POSTGRADUATE PRESS, INC.
  8. Uzun, O., Cansever, A., Basoglu, C., & Ozsahin, A., 2003. Smoking and substance abuse in outpatients with schizophrenia: A 2-year follow-up study in turkey. Drug Alcohol Depend. 70(2):187-92.

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Authors
Myles, N., Newall, H. D., Curtis, J., Nielssen, O., Shiers, D., & Large, M.
Affiliations
UNSW Sydney (AU)
Venue
The Journal of Clinical Psychiatry
Published
2012-04-15
Volume
73
Issue
04
Pages
468-475
ISSN
0160-6689 (ISSN-L)
OpenAlex
W2036557906
Cited by
158
References
84
Citations by year
2026: 4 · 2025: 7 · 2024: 8 · 2023: 9 · 2022: 13 · 2021: 11 · 2020: 17 · 2019: 10 · 2018: 13 · 2017: 11 · 2016: 16 · 2015: 23 · 2014: 9 · 2013: 5 · 2012: 2
FWCI
1.36
Type
journal article
Language
en
Open access
Locations
  • The Journal of Clinical Psychiatry (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Physiology › Smoking Behavior and Cessation
  • Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
  • Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
Keywords
tobacco use, smoking, first-episode psychosis, schizophrenia, nicotine, prevalence, antipsychotic drugs, tobacco cessation, cardiovascular risk, mental illness
MeSH terms
Affective Disorders, Psychotic, Humans, Psychotic Disorders, Schizophrenia, Tobacco Use Disorder, Prevalence

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