Worldwide prevalence of smoking cessation in schizophrenia patients: A meta-analysis of comparative and observational studies

Zeng, Liang; Zong, Qiao; Zhang, Ling; Feng, Yuan; Ng, Chee H.; Ungvári, Gábor S.; Chen, Li Gang; Xiang, Yu Tao

doi:10.1016/j.ajp.2020.102190

Cited by 26 publications

(18 citation statements)

References 54 publications

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“…Cessation rates were almost twice as high compared to an UHR population studied by Ward et al [56] (5.5% cessation) in which smoking cessation was evaluated over a longer follow-up period (2-year). Sustained quitting is associated with a shorter follow-up period [57] which might be a plausible explanation for higher cessation rates in the current study. In a FEP population, 3.9% quitted smoking during a 15-month follow-up period [58].…”

Section: Discussionmentioning

confidence: 89%

Impact of smoking behavior on cognitive functioning in persons at risk for psychosis and healthy controls: A longitudinal study

et al. 2021

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Background The high prevalence of smoking in individuals who are at ultra-high risk (UHR) for psychosis is well known and moderate cognitive deficits have also been found in UHR. However, the association between smoking and cognition in UHR is unknown and longitudinal studies are lacking. Method A cohort study with 330 UHR individuals and 66 controls was conducted, as part of the European network of national schizophrenia networks studying gene–environment interactions (EU-GEI). At baseline and after 6, 12, and 24 months, smoking behavior was assessed with the Composite International Diagnostic Interview and cognitive functioning with a comprehensive test battery. Linear mixed-effects analyses were used to examine the multicross-sectional and prospective associations between (change in) smoking behavior and cognitive functioning, accounting for confounding variables. Results At baseline, 53% of UHR and 27% of controls smoked tobacco. Smoking UHR and controls did not significantly differ from nonsmoking counterparts on the tested cognitive domains (speed of processing, attention/vigilance, working memory, verbal learning, or reasoning/problem solving) across different assessment times. Neither smoking cessation nor initiation was associated with a significant change in cognitive functioning in UHR. Conclusions No associations were found between smoking and cognitive impairment in UHR nor in controls. However, the fact that one in every two UHR individuals report daily use of tobacco is alarming. Our data suggest that UHR have fewer cognitive impairments and higher smoking cessation rates compared to patients with first-episode psychosis found in literature. Implications to promote smoking cessation in the UHR stage need further investigation.

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Section: Discussionmentioning

confidence: 89%

Impact of smoking behavior on cognitive functioning in persons at risk for psychosis and healthy controls: A longitudinal study

et al. 2021

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“…Abnormalities in glucose regulation, lipid metabolism, feeding and energy sensing, have been reported from the earliest stages of illness, including the prodrome, and in unaffected siblings 4,43 . Furthermore, behavioral factors such as smoking, poor dietary habits, and low‐physical activity 59–65 ; biological factors such as increased inflammation, disruptions in the hypothalamic‐pituitary‐adrenal (HPA) axis, aberrant adipose tissue homeostasis, and brain insulin resistance 66–70 ; and systemic factors such as low socioeconomic status and barriers to care 71–73 interact and overlap to drive metabolic dysfunction, including the adiposity changes reported in the present study 8 …”

Section: Discussionmentioning

confidence: 99%

Adiposity in schizophrenia: A systematic review and meta‐analysis

Smith

Singh

Lee

et al. 2021

Acta Psychiatr Scand

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Objective Although a relationship between schizophrenia (SCZ), antipsychotic (AP) medication, and metabolic dysregulation is now well established, the effect of adiposity is less well understood. By synthesizing findings from imaging techniques that measure adiposity, our systematic review and meta‐analysis (PROSPERO CRD42020192977) aims to determine the adiposity‐related effects of illness and treatment in this patient population. Methods We searched MEDLINE, EMBASE, PsychINFO and Scopus for all relevant case‐control and prospective longitudinal studies from inception until February 2021. Measures of adiposity including percent body fat (%BF), subcutaneous adipose tissue (SAT), and visceral adipose tissue (VAT) were analyzed as primary outcomes. Results Our search identified 29 articles that used imaging methods to quantify adiposity among patients with SCZ spectrum disorders. Analyses revealed that patients have greater %BF (mean difference (MD) = 3.09%; 95% CI: 0.75–5.44), SAT (MD = 24.29 cm2; 95% CI: 2.97–45.61) and VAT (MD = 33.73 cm2, 95% CI: 4.19–63.27) compared to healthy controls. AP treatment was found to increase SAT (MD = 31.98 cm2; 95% CI: 11.33–52.64) and VAT (MD = 16.30 cm2; 95% CI: 8.17–24.44) with no effect on %BF. However, change in %BF was higher for AP‐free/AP‐naïve patients compared to treated patients. Conclusion Our findings indicate that patients with SCZ spectrum disorders have greater adiposity than healthy controls, which is increased by AP treatment. Young, AP‐naïve patients may be particularly susceptible to this effect. Future studies should explore the effect of specific APs on adiposity and its relation to overall metabolic health.

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“…A recent meta-analysis reported the prevalence of smoking cessation in participants with schizophrenia to be 14.5%, compared to 23.1% in healthy controls and 19.6% in those with other psychiatric illnesses [ 74 ]. However, the comparatively low prevalence of smoking cessation in schizophrenia may be representative of ineffective smoking cessation policies or strategies in that population, rather than corroborative of neurobiological theories as to why the prevalence is lower.…”

Section: Reviewmentioning

confidence: 99%

Cigarette Smoking and Schizophrenia: Etiology, Clinical, Pharmacological, and Treatment Implications

Ding

2021

Schizophrenia Research and Treatment

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Recent data suggests that the prevalence of smoking in schizophrenia remains high. While reports suggest that smoking increases the risk of developing schizophrenia, the potential causative role of smoking in this relationship needs further investigation. Smokers with schizophrenia are more likely to have more intense positive symptoms and lower cognitive function, but diminished intensity of extrapyramidal side effects than nonsmoking patients with schizophrenia. They were also more likely to exhibit aggressive behaviour compared to nonsmokers, which could suggest higher levels of baseline aggression. The significant cost associated with regular tobacco expenditure can detract from investment in key domains. Large-scale trials have shown that pharmacotherapy for smoking cessation is effective and does not worsen the risk of developing neuropsychiatric symptoms compared to placebo. Electronic cigarette use among schizophrenia patients is high, and there is emerging evidence supportive of its efficacy. Future improvements include large-scale trials assessing the utility, efficacy, and safety of electronic cigarettes in schizophrenia patients.

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Worldwide prevalence of smoking cessation in schizophrenia patients: A meta-analysis of comparative and observational studies

Cited by 26 publications

References 54 publications

Impact of smoking behavior on cognitive functioning in persons at risk for psychosis and healthy controls: A longitudinal study

Impact of smoking behavior on cognitive functioning in persons at risk for psychosis and healthy controls: A longitudinal study

Adiposity in schizophrenia: A systematic review and meta‐analysis

Cigarette Smoking and Schizophrenia: Etiology, Clinical, Pharmacological, and Treatment Implications

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