Taylor Gemma M J, Treur Jorien L
Department of Psychology, University of Bath, 10 West, Bath BA2 7AY, United Kingdom.
Department of Psychiatry, University of Amsterdam, Amsterdam UMC, Amsterdam, the Netherlands.
Int J Clin Health Psychol. 2023 Jan-Apr;23(1):100335. doi: 10.1016/j.ijchp.2022.100335. Epub 2022 Oct 1.
Worldwide, approximately 24% of all adults smoke, but smoking is up to twice as prevalent in people with mental ill-health. There is growing evidence that smoking may be a causal risk factor in the development of mental illness, and that smoking cessation leads to improved mental health.
In this scholarly review we have: (1) used a modern adaptation of the Bradford-Hill criteria to bolster the argument that smoking could cause mental ill-health and that smoking cessation could reverse these effects, and (2) by considering psychological, biological, and environmental factors, we have structured the evidence to-date into a stress-diathesis model.
Our model suggests that smoking is a psychobiological stressor, but that the magnitude of this effect is mediated and modulated by the individual's diathesis to develop mental ill-health and other vulnerability and protective factors. We explore biological mechanisms that underpin the model, such as tobacco induced damage to neurological systems and oxidative stress pathways. Furthermore, we discuss evidence indicating that it is likely that these systems repair after smoking cessation, leading to better mental health.
Based on a large body of literature including experimental, observational, and novel causal inference studies, there is consistent evidence showing that smoking can negatively affect the brain and mental health, and that smoking cessation could reverse the mental ill-health caused by smoking. Our model suggests that smoking prevention and treatment strategies have a role in preventing and treating mental illness as well as physical illness.
在全球范围内，约24%的成年人吸烟，但在精神健康状况不佳的人群中，吸烟率高达两倍。越来越多的证据表明，吸烟可能是精神疾病发展的一个因果风险因素，而戒烟可改善心理健康。
在本学术综述中，我们：（1）采用了现代版的布拉德福德-希尔标准，以支持吸烟可能导致精神健康不佳以及戒烟可逆转这些影响的观点；（2）通过考虑心理、生物和环境因素，我们将迄今为止的证据构建成一个应激-素质模型。
我们的模型表明，吸烟是一种心理生物学应激源，但这种影响的程度由个体发展为精神健康不佳的素质以及其他脆弱性和保护因素所介导和调节。我们探索了该模型背后的生物学机制，如烟草对神经系统和氧化应激途径的损害。此外，我们讨论了表明戒烟后这些系统可能修复从而带来更好心理健康的证据。
基于包括实验、观察和新型因果推断研究在内的大量文献，有一致的证据表明吸烟会对大脑和心理健康产生负面影响，而戒烟可以逆转吸烟所致的精神健康不佳。我们的模型表明，吸烟预防和治疗策略在预防和治疗精神疾病以及身体疾病方面都发挥着作用。
