Tobacco use before, at, and after first-episode psychosis: a systematic meta-analysis.Journal: Journal of Clinical Psychiatry. 2012 April, Volume 73(4), Pages 468-475.
Authors: Myles N, Newall HD, Curtis J, Nielssen O, Shiers D, Large M.
Source: Coffs Harbour Health Campus, Coffs Harbour.
OBJECTIVE: Patients with first-episode psychosis have a high prevalence of tobacco use. We aimed to examine the prevalence and course of tobacco use during early psychosis using meta-analysis.
DATA SOURCES: Systematic search of MEDLINE (1948-2011), Embase (1947-2011), CINAHL (1984-2011), PsycINFO (1967-2011), and ISI Web of Science (1900-2011) using the search terms [psychosis OR schizophrenia] AND [tobacco OR smoking OR nicotine].
STUDY SELECTION: We located 10 studies reporting the age at initiation of daily tobacco use and the age at onset of psychosis, 31 studies reporting prevalence of tobacco use in patients with first-episode psychosis, 10 studies comparing smoking to age-/gender-matched controls, and 7 studies reporting prevalence of tobacco use at intervals after treatment.
DATA EXTRACTION: The following data were extracted: age at initiation of daily tobacco use and at onset of psychosis, the proportion of patients with first-episode psychosis who used tobacco, the proportion of the general population who used tobacco, and the proportion of patients with psychosis who used tobacco at various intervals after initiation of antipsychotic treatment.
RESULTS: The pooled estimate for the interval between initiation of tobacco use and the onset of psychosis was 5.3 years (standardized mean difference = 0.85). The estimated prevalence of tobacco users in first episode of psychosis is 58.9% (95% CI, 54.3%-63.4%). There is a strong association between first-episode psychosis and tobacco use (OR = 6.04; 95% CI, 3.03-12.02) compared with healthy controls. The prevalence of tobacco use at intervals between 6 and 120 months after treatment remained unchanged (OR = 0.996; 95% CI, 0.907-1.094).
CONCLUSIONS: Patients with first-episode psychosis tend to have smoked for some years prior to the onset of psychosis, have high prevalence of tobacco use at the time of presenting for treatment, and are much more likely to smoke than aged-matched controls. Their apparent difficulty in quitting has implications for tobacco cessation programs and efforts to reduce cardiovascular disease among people with mental illness.
© Copyright 2012 Physicians Postgraduate Press, Inc.
PMID: 22579146 [PubMed - in process]
PubMed Link: http://www.ncbi.nlm.nih.gov/pubmed/22579146
Looking at the below study abstract, what does it say when 82% of mental health patients say that they want to quit or reduce smoking while 91% of psychiatrists believe that patients don't want to quit? To my thinking, and just as strange, is that most of the authors of the below study are NRT or e-cig advocates who know amazingly little about nicotine cessation. You see, more than 200 NRT clinical trials did not check body fluids at study's end for the presence of nicotine or its major metabolite, cotinine.
Community Ment Health J. 2016 Nov 30. [Epub ahead of print]
Smoking Cessation and Electronic Cigarettes in Community Mental Health Centers: Patient and Provider Perspectives.Chen LS, Baker T, Brownson RC, Carney RM, Jorenby D, Hartz S, Smock N, Johnson M, Ziedonis D, Bierut LJ.
AbstractLittle is known about patients' electronic cigarette use, interest in and use of smoking cessation treatments, and providers' attitude towards such treatment. We assessed patients (N = 231) and providers (45 psychiatrists, 97 case workers) in four Community Mental Health Centers. Interestingly, 50% of smokers reported interest in using electronic cigarettes to quit smoking, and 22% reported current use. While 82% of smokers reported wanting to quit or reduce smoking, 91% of psychiatrists and 84% of case workers reported that patients were not interested in quitting as the lead barrier, limiting the provision of cessation interventions. Providers' assumption of low patient interest in treatment may account for the low rate of smoking cessation treatment. In contrast, patients report interest and active use of electronic cigarettes to quit smoking. This study highlights the need for interventions targeting different phases of smoking cessation in these patients suffering disproportionately from tobacco dependence.
KEYWORDS: Electronic cigarettes; Implementation; Mental illness; Smoking cessation
PMID: 27900650DOI: 10.1007/s10597-016-0065-8
PubMed Study Abstract Link: https://www.ncbi.nlm.nih.gov/pubmed/27900650