Tobacco smoking and nicotine dependence in first episode and established psychosis

Lally, John, Spaducci, Gilda, Gardner-Sood, Poonam, Atakan, Zerrin, Greenwood, Kathy, Di Forti, Marta, Ismail, Khalida, Murphy, Kieran C., Smith, Shubulade, McNeill, Ann, Murray, Robin M. and Gaughran, Fiona (2019) Tobacco smoking and nicotine dependence in first episode and established psychosis. Asian Journal of Psychiatry, 43. pp. 125-131. ISSN 18762018

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Abstract

Aim
People with psychotic disorders have increased premature mortality in comparison with the general population, with high rates of cigarette use a contributing factor. We aimed to describe the prevalence of cigarette use and nicotine dependence (ND) in first episode psychosis (FEP), and established psychosis; and to investigate associations between clinical symptoms and ND.

Methodology
Smoking and clinical data were collected from two cohorts: 181 people with FEP recruited as part of the Physical Health and Substance Use Measures in First Onset Psychosis (PUMP) study and from 432 people with established psychosis recruited as part of the Improving
physical health and reducing substance use in psychosis randomised controlled trial (IMPaCT RCT).

Results
The prevalence of cigarette smoking was 78% in FEP and 62% in established psychosis. Forty nine percent (n=60) of smokers in the FEP cohort and 69% (n=183) of smokers with established psychosis were highly nicotine dependent. Being a highly nicotine dependent
smoker was significantly associated with higher PANSS positive symptom scores (F= 5.480 p= 0.004), and with decreased scores on the Rosenberg self-esteem scale (F=3.261, p=0.039) in established psychosis. There was no diagnostic specificity identified in relation to smoking or ND in both groups.

Conclusion
High rates of cigarette usage and nicotine dependence are problems from the early stages of psychosis. ND is higher in people with established psychosis. Smoking cessation
strategies as part of comprehensive management of psychotic disorders at every stage require further development and evaluation.

Item Type: Article
Keywords: Schizophrenia; psychotic; smoking; substance use; addiction; physical health
Schools and Departments: School of Psychology > Psychology
Depositing User: Sanjeedah Choudhury
Date Deposited: 27 Sep 2019 16:10
Last Modified: 04 May 2020 01:00
URI: http://sro.sussex.ac.uk/id/eprint/86329

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