Department of Psychosis Studies,Institute of Psychiatry, Psychology and Neuroscience, King's College London,London.
Department of Psychological Medicine,Institute of Psychiatry, Psychology and Neuroscience, King's College London,London.
Psychol Med. 2018 Jan;48(1):123-131. doi: 10.1017/S0033291717001556. Epub 2017 Jun 28.
The association between cigarette smoking and psychosis remains unexplained, but could relate to causal effects in both directions, confounding by socioeconomic factors, such as ethnicity, or use of other substances, including cannabis. Few studies have evaluated the association between cigarettes and psychotic experiences (PEs) in diverse, inner-city populations, or relationships with number of cigarettes consumed.
We assessed associations and dose-response relationships between cigarette smoking and PEs in a cross-sectional survey of household residents (n = 1680) in South East London, using logistic regression to adjust for cannabis use, other illicit substances, and socioeconomic factors, including ethnicity.
We found association between any PEs and daily cigarette smoking, which remained following adjustment for age, gender, ethnicity, cannabis and use of illicit stimulant drugs (fully adjusted odds ratio 1.47, 95% confidence interval 1.01-2.15). Fully adjusted estimates for the association, and with number of PEs, increased with number of cigarettes smoked daily, implying a dose-response effect (p = 0.001 and <0.001, respectively). Odds of reporting any PEs in ex-smokers were similar to never-smokers.
In this diverse epidemiological sample, association between smoking and PEs was not explained by confounders such as cannabis or illicit drugs. Daily cigarette consumption showed a dose-response relationship with the odds of reporting PEs, and of reporting a greater number of PEs. There was no difference in odds of reporting PEs between ex-smokers and never-smokers, raising the possibility that the increase in PEs associated with smoking may be reversible.
吸烟与精神病之间的关联仍未得到解释，但可能与两者之间的因果关系有关，混杂因素包括社会经济因素，如种族，或使用其他物质，包括大麻。很少有研究评估在不同的、城市内城区人群中吸烟与精神病体验（PEs）之间的关联，或与吸烟数量的关系。
我们使用逻辑回归来调整大麻使用、其他非法药物以及包括种族在内的社会经济因素，评估了在伦敦东南部家庭居民（n = 1680）的横断面调查中吸烟与 PEs 之间的关联和剂量反应关系。
我们发现任何 PEs 与每日吸烟之间存在关联，这种关联在调整年龄、性别、种族、大麻和使用非法兴奋剂药物后仍然存在（完全调整后的比值比 1.47，95%置信区间 1.01-2.15）。完全调整后的关联估计值，以及与 PEs 数量的关联，随着每天吸烟数量的增加而增加，表明存在剂量反应效应（p = 0.001 和 <0.001，分别）。报告任何 PEs 的前吸烟者的几率与从不吸烟者相似。
在这个多样化的流行病学样本中，吸烟与 PEs 之间的关联不能用大麻或非法药物等混杂因素来解释。每天吸烟量与报告 PEs 的几率以及报告更多 PEs 的几率呈剂量反应关系。前吸烟者与从不吸烟者报告 PEs 的几率没有差异，这表明与吸烟相关的 PEs 增加可能是可逆的。
