Koyanagi A, Stickley A, Haro J M
Parc Sanitari Sant Joan de Déu, Universitat de Barcelona, Fundació Sant Joan de Déu, Barcelona, Spain.
Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain.
Acta Psychiatr Scand. 2016 Jun;133(6):497-505. doi: 10.1111/acps.12566. Epub 2016 Mar 30.
To assess the association between psychotic symptoms and smoking among community-dwelling adults in 44 countries.
Data from the World Health Survey (WHS) for 192 474 adults aged ≥18 years collected in 2002-2004 were analyzed. The Composite International Diagnostic Interview was used to identify four types of past 12-month psychotic symptoms. Smoking referred to current daily and non-daily smoking. Heavy smoking was defined as smoking ≥30 tobacco products/day.
The pooled age-sex-adjusted OR (95% CI) of psychotic symptoms (i.e., at least one psychotic symptom) for smoking was 1.35 (1.27-1.43). After adjustment for potential confounders, compared to those with no psychotic symptoms, the ORs (95% CIs) for smoking for 1, 2, and ≥3 psychotic symptoms were 1.20 (1.08-1.32), 1.25 (1.08-1.45), and 1.36 (1.13-1.64) respectively. Among daily smokers, psychotic symptoms were associated with heavy smoking (OR = 1.45, 95% CI = 1.10-1.92), and individuals who initiated daily smoking at ≤15 years of age were 1.22 (95% CI = 1.05-1.42) times more likely to have psychotic symptoms.
An increased awareness that psychotic symptoms are associated with smoking is important from a public health and clinical point of view. Future studies that investigate the underlying link between psychotic symptoms and smoking prospectively are warranted.
评估44个国家社区居住成年人中精神病性症状与吸烟之间的关联。
分析了2002 - 2004年收集的来自世界卫生调查（WHS）的192474名18岁及以上成年人的数据。采用综合国际诊断访谈来识别过去12个月内四种类型的精神病性症状。吸烟指当前每日和非每日吸烟。重度吸烟定义为每天吸食≥30支烟草制品。
吸烟的精神病性症状（即至少一种精神病性症状）的合并年龄 - 性别调整后的OR（95%CI）为1.35（1.27 - 1.43）。在对潜在混杂因素进行调整后，与无精神病性症状者相比，有1种、2种及≥3种精神病性症状者吸烟的OR（95%CI）分别为1.20（1.08 - 1.32）、1.25（1.08 - 1.45）和1.36（1.13 - 1.64）。在每日吸烟者中，精神病性症状与重度吸烟相关（OR = 1.45，95%CI = 1.10 - 1.92），15岁及以下开始每日吸烟的个体出现精神病性症状的可能性高1.22倍（95%CI = 1.05 - 1.42）。
从公共卫生和临床角度来看，提高对精神病性症状与吸烟相关的认识很重要。有必要开展前瞻性研究来探究精神病性症状与吸烟之间的潜在联系。
