It’s been found that people with psychotic disorders (severe mental disorders including schizophrenia and bipolar disorder that cause abnormal thinking and perceptions) have an increased propensity to smoke cigarettes.

The reasons are not entirely clear. However theories include self- medication, trying to correct chemical imbalances inherent to the disorders, or smoking as a coping mechanism to relieve anxiety and stress.

While this association has been acknowledged for sometime there’s been little research into whether smoking cigarettes might actually increase people’s risk of developing psychotic disorders.

Researchers reviewed the available evidence to investigate the link between tobacco use and the development of psychotic disorder.

Four hypotheses were investigated:

  • Firstly, that excess tobacco use is already present in people presenting with their first episode of psychosis;
  • Secondly, that daily tobacco use is associated with an increased risk of subsequent psychotic disorder;
  • Thirdly, that daily tobacco use is associated with an earlier age at onset of psychotic illness;
  • Finally, that commencing smoking at an earlier age is associated with an increased risk of psychotic disorder.

Studies involving a range of psychotic disorders were reviewed including schizophrenia, delusional disorder, non-affective psychotic disorder, psychotic depression and bipolar mania.

Researchers found that, compared with non-smokers, daily smokers had a higher risk of incidence of new psychotic disorders. Furthermore, daily smokers had an earlier onset of psychotic illness than non-smokers.

Implications

Further research needs to be done to tease out the possible association between smoking cigarettes and the development of psychotic disorder. The degree of risk observed in this analysis was modest.

Nevertheless, the damage smoking cigarettes do to our health is undeniable and the benefits of quitting are very well documented.

Smoking increases the risk of most chronic diseases and substantially shortens lifespan.

The benefits of quitting smoking are immediate so if you haven’t already kicked the habit the sooner you do, the better.

Last Reviewed: 28/09/2019

© Norman Swan Medical Communications.



References

Gurillon, P et al. Does tobacco use cause psychosis? Systematic review and meta-analysis. Lancet Psychiatry 2015 Published Online July 10, 2015 http://dx.doi.org/10.1016/S2215-0366(15)00152-2