A Mustonen1,2, T Ahokas1, T Nordström1,2, G K Murray3, P Mäki2,4,5,6,7,8,9,10, E Jääskeläinen1,2,5, A Heiskala1, J J Mcgrath11,12,13, J G Scott12,14,15, J Miettunen1,2, S Niemelä4,16. 1. Center for Life Course Health Research, University of Oulu, Oulu, Finland. 2. Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland. 3. Department of Psychiatry, University of Cambridge, Cambridge, UK. 4. Department of Psychiatry, Research Unit of Clinical Neuroscience, University of Oulu, Oulu, Finland. 5. Department of Psychiatry, Oulu University Hospital, the Northern Ostrobothnia Hospital District, Oulu, Finland. 6. Department of Psychiatry, Länsi-Pohja Healthcare District, Tornio, Finland. 7. Department of Psychiatry, the Middle Ostrobothnia Central Hospital, Soite, Kokkola, Finland. 8. Mental Health Services, Joint Municipal Authority of Wellbeing in Raahe District, Raahe, Finland. 9. Mental Health Services, Basic Health Care District of Kallio, Ylivieska, Finland. 10. Department of Psychiatry, Kainuu Central Hospital, Kainuu Social and Healthcare District, Kajaani, Finland. 11. Queensland Brain Institute, The University of Queensland, St Lucia, Qld, Australia. 12. Queensland Centre for Mental Health Research, The Park Centre for Mental Health, Wacol, Qld, Australia. 13. National Centre for Register-Based Research, Aarhus University, Business and Social Sciences, Aarhus, Denmark. 14. Faculty of Medicine, University of Queensland Centre for Clinical Research, The University of Queensland, Herston, Qld, Australia. 15. Metro North Mental Health, Royal Brisbane and Women's Hospital, Herston, Qld, Australia. 16. Department of Psychiatry, Lapland Hospital District, Rovaniemi, Finland.
Abstract
OBJECTIVE: 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. METHODS: 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. RESULTS: 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). CONCLUSION: Heavy tobacco smoking in adolescence was associated with a greater risk for psychosis even after adjustment for confounders.
OBJECTIVE: 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. METHODS: 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. RESULTS: 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). CONCLUSION: Heavy tobacco smoking in adolescence was associated with a greater risk for psychosis even after adjustment for confounders.
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