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Tobacco use in first-episode psychosis, a multinational EU-GEI study

Published online by Cambridge University Press:  26 April 2023

T. Sánchez-Gutiérrez Open the ORCID record for T. Sánchez-Gutiérrez [Opens in a new window] ,
E. Rodríguez-Toscano ,
L. Roldán ,
L. Ferraro ,
M. Parellada ,
A. Calvo ,
G. López ,
M. Rapado-Castro ,
D. La Barbera  and
C. La Cascia
...Show all authors
T. Sánchez-Gutiérrez*
Affiliation:
Faculty of Health Science, Universidad Internacional de la Rioja (UNIR), Logroño, Spain
E. Rodríguez-Toscano
Affiliation:
Grupo de investigación en Psiquiatría, Hospital Clínico San Carlos, IdISSC, Madrid, Spain Department of Experimental Psychology, Cognitive Processes and Speech Therapy at the Complutense University of Madrid, Madrid, Spain
L. Roldán
Affiliation:
Faculty of Psychology, Universidad Complutense de Madrid, Madrid, Spain
L. Ferraro
Affiliation:
Department of Biomedicine, Neuroscience and Advanced Diagnostics (BiND), Psychiatry Section, University of Palermo, Palermo, Italy
M. Parellada
Affiliation:
Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, IiSGM, CIBERSAM, School of Medicine, Universidad Complutense, Madrid, Spain
A. Calvo
Affiliation:
Faculty of Psychology, Universidad Complutense de Madrid, Madrid, Spain
G. López
Affiliation:
Faculty of Health Science, Universidad Internacional de la Rioja (UNIR), Logroño, Spain
M. Rapado-Castro
Affiliation:
Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, IiSGM, CIBERSAM, School of Medicine, Universidad Complutense, Madrid, Spain Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne and Melbourne Health, 161 Barry Street, Carlton South, Victoria 3053, Australia
D. La Barbera
Affiliation:
Department of Biomedicine, Neuroscience and Advanced Diagnostics (BiND), Psychiatry Section, University of Palermo, Palermo, Italy
C. La Cascia
Affiliation:
Department of Biomedicine, Neuroscience and Advanced Diagnostics (BiND), Psychiatry Section, University of Palermo, Palermo, Italy
G. Tripoli
Affiliation:
Department of Biomedicine, Neuroscience and Advanced Diagnostics (BiND), Psychiatry Section, University of Palermo, Palermo, Italy
M. Di Forti
Affiliation:
Department of Social Genetics and Developmental Psychiatry, Institute of Psychiatry Psychology & Neuroscience, King's College London, London, UK South London and Maudsley NHS Foundation Mental Health Trust, London, UK
R. M. Murray
Affiliation:
Department of Social Genetics and Developmental Psychiatry, Institute of Psychiatry Psychology & Neuroscience, King's College London, London, UK
D. Quattrone
Affiliation:
Department of Social Genetics and Developmental Psychiatry, Institute of Psychiatry Psychology & Neuroscience, King's College London, London, UK
C. Morgan
Affiliation:
ESRC Centre for Society and Mental Health, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
J. van Os
Affiliation:
Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, South Limburg Mental Health Research and Teaching Network, Maastricht University Medical Centre, P.O. Box 616, 6200 MD Maastricht, The Netherlands Department Psychiatry, Brain Centre Rudolf Magnus, Utrecht University Medical Centre, Utrecht, The Netherlands
P. García-Portilla
Affiliation:
Department of Medicine-Psychiatry, Universidad de Oviedo, ISPA, INEUROPA, CIBERSAM, Oviedo, Spain
S. Al-Halabí
Affiliation:
Department of Psychology, University of Oviedo, Oviedo, Spain
J. Bobes
Affiliation:
Department of Medicine-Psychiatry, Universidad de Oviedo, ISPA, INEUROPA, CIBERSAM, Oviedo, Spain
L. de Haan
Affiliation:
Early Psychosis Department, Amsterdam UMC, University of Amsterdam, Academic Psychiatric Centre, Arkin, Amsterdam, The Netherlands
M. Bernardo
Affiliation:
Barcelona Clinic Schizophrenia Unit, Hospital Clinic, Departament de Medicina, Institut de Neurociències (UBNeuro), Universitat de Barcelona (UB), Institut d’Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS), CIBERSAM, ISCIII, Barcelona, Spain
J. L. Santos
Affiliation:
Department of Psychiatry, Servicio de Psiquiatría Hospital ‘Virgen de la Luz’, Cuenca, Spain
J. Sanjuán
Affiliation:
Department of Psychiatry, Hospital Clínico Universitario de Valencia, INCLIVA, CIBERSAM, School of Medicine, Universidad de Valencia, Valencia, Spain
M. Arrojo
Affiliation:
Department of Psychiatry, Psychiatric Genetic Group, Instituto de Investigación Sanitaria de Santiago de Compostela, Complejo Hospitalario Universitario de Santiago de Compostela, Santiago de Compostela, Spain
A. Ferchiou
Affiliation:
Fondation FondaMental, Univ Paris Est Creteil, INSERM, IMRB, F-94010 Creteil, France AP-HP, Hopitaux Universitaires ‘H. Mondor’, DMU IMPACT, F-94010 Creteil, France
A. Szoke
Affiliation:
Fondation FondaMental, Univ Paris Est Creteil, INSERM, IMRB, F-94010 Creteil, France AP-HP, Hopitaux Universitaires ‘H. Mondor’, DMU IMPACT, F-94010 Creteil, France
B. P. Rutten
Affiliation:
Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, South Limburg Mental Health Research and Teaching Network, Maastricht University Medical Centre, Maastricht, The Netherlands
S. Stilo
Affiliation:
Department of Mental Health and Addiction Services, ASP Crotone, Crotone, Italy
G. D'Andrea
Affiliation:
Department of Medical and Surgical Science, Psychiatry Unit, Alma Mater Studiorum Università di Bologna, Bologna, Italy
I. Tarricone
Affiliation:
Department of Medical and Surgical Science, Psychiatry Unit, Alma Mater Studiorum Università di Bologna, Bologna, Italy
C. M. Díaz-Caneja
Affiliation:
Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, IiSGM, CIBERSAM, School of Medicine, Universidad Complutense, Madrid, Spain
C. Arango
Affiliation:
Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, IiSGM, CIBERSAM, School of Medicine, Universidad Complutense, Madrid, Spain
*
Author for correspondence: T. Sánchez-Gutiérrez, E-mail: teresa.sanchez@unir.net
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Abstract

Background

Tobacco is a highly prevalent substance of abuse in patients with psychosis. Previous studies have reported an association between tobacco use and schizophrenia. The aim of this study was to analyze the relationship between tobacco use and first-episode psychosis (FEP), age at onset of psychosis, and specific diagnosis of psychosis.

Methods

The sample consisted of 1105 FEP patients and 1355 controls from the European Network of National Schizophrenia Networks Studying Gene–Environment Interactions (EU-GEI) study. We assessed substance use with the Tobacco and Alcohol Questionnaire and performed a series of regression analyses using case-control status, age of onset of psychosis, and diagnosis as outcomes and tobacco use and frequency of tobacco use as predictors. Analyses were adjusted for sociodemographic characteristics, alcohol, and cannabis use.

Results

After controlling for cannabis use, FEP patients were 2.6 times more likely to use tobacco [p ⩽ 0.001; adjusted odds ratio (AOR) 2.6; 95% confidence interval (CI) [2.1–3.2]] and 1.7 times more likely to smoke 20 or more cigarettes a day (p = 0.003; AOR 1.7; 95% CI [1.2–2.4]) than controls. Tobacco use was associated with an earlier age at psychosis onset (β = −2.3; p ⩽ 0.001; 95% CI [−3.7 to −0.9]) and was 1.3 times more frequent in FEP patients with a diagnosis of schizophrenia than in other diagnoses of psychosis (AOR 1.3; 95% CI [1.0–1.8]); however, these results were no longer significant after controlling for cannabis use.

Conclusions

Tobacco and heavy-tobacco use are associated with increased odds of FEP. These findings further support the relevance of tobacco prevention in young populations.

Keywords

Age of psychosis onsetheavy useschizophreniasmokingsubstance usetobacco
Type
Original Article
Information
Psychological Medicine , Volume 53 , Issue 15 , November 2023 , pp. 7265 - 7276
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Copyright
Copyright © The Author(s), 2023. Published by Cambridge University Press

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Footnotes

*

Drs Arango and Díaz-Caneja contributed equally to this work.

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