Center for Life Course Health Research, University of Oulu, Oulu, Finland.
Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland.
Acta Psychiatr Scand. 2018 Jul;138(1):5-14. doi: 10.1111/acps.12863. Epub 2018 Feb 18.
Daily smoking has been associated with a greater risk of psychosis. However, we are still lacking studies to adjust for baseline psychotic experiences and other substance use. We examined associations between daily smoking and psychosis risk in a 15-year follow-up while accounting for these covariates in a prospective sample (N = 6081) from the Northern Finland Birth Cohort 1986.
Self-report questionnaires on psychotic experiences (PROD-screen), tobacco smoking and other substance use were completed when the cohort members were 15-16 years old. Tobacco smoking was categorized into three groups (non-smokers, 1-9 cigarettes and ≥10 cigarettes/day). Psychosis diagnoses were obtained from national registers until the age of 30 years.
Subjects in heaviest smoking category were at increased risk of subsequent psychosis (unadjusted HR = 3.15; 95% CI 1.94-5.13). When adjusted for baseline psychotic experiences the association persisted (HR = 2.87; 1.76-4.68) and remained significant even after adjustments for multiple known risk factors such as cannabis use, frequent alcohol use, other illicit substance use, parental substance abuse, and psychosis. Furthermore, number of smoked cigarettes increased psychosis risk in a dose-response manner (adjusted OR = 1.05; 1.01-1.08).
Heavy tobacco smoking in adolescence was associated with a greater risk for psychosis even after adjustment for confounders.
每日吸烟与更高的精神病风险相关。然而，我们仍然缺乏研究来调整基线精神病体验和其他物质使用。我们在一项前瞻性样本（N=6081）中，从芬兰北部出生队列 1986 年的 15 年随访中，检查了每日吸烟与精神病风险之间的关联，同时考虑了这些协变量。
当队列成员 15-16 岁时，完成了关于精神病体验（PROD-屏幕）、吸烟和其他物质使用的自我报告问卷。吸烟分为三组（不吸烟者、每天 1-9 支烟和≥10 支烟）。精神病诊断从国家登记处获得，直至 30 岁。
吸烟最多的人群发生后续精神病的风险增加（未调整的 HR=3.15；95%CI 1.94-5.13）。在调整基线精神病体验后，这种关联仍然存在（HR=2.87；1.76-4.68），即使在调整了大麻使用、频繁饮酒、其他非法物质使用、父母物质滥用和精神病等多种已知风险因素后，这种关联仍然显著。此外，吸烟数量与精神病风险呈剂量反应关系（调整后的 OR=1.05；1.01-1.08）。
青少年时期重度吸烟与精神病风险增加相关，即使在调整了混杂因素后也是如此。
