title: Association between tobacco smoking and bipolar affective disorder: clinical, epidemiological, cross-sectional, retrospective study in outpatients.
abstract: OBJECTIVE
  Although high rates of smoking have been reported among psychiatric patients, only a few studies examined the prevalence of smoking in bipolar disorder, and findings are inconsistent. We investigated smoking among bipolar patients.
  
  
  METHODS
  We examined the prevalence of smoking in of 102 patients that met Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition criteria for bipolar I disorder in Israel and evaluated the relationship between smoking and demographic and clinical data.
  
  
  RESULTS
  Fifty-five of the bipolar patients (53.9%) smoked, with a rate that is 2.36 times higher than among the general population in Israel (22.8%). Significant relationships were revealed between smoking and lifetime history of alcohol dependence/abuse (P = .02), between smoking and history of drug use (P ≤ .01), and between smoking and age of illness onset (P = .04).
  
  
  CONCLUSIONS
  The cross-sectional nature of the study and the relatively small sample size preclude generalization of the findings. Nicotine levels were not measured; thus, the information regarding smoking was subjective.
  
  
  CONCLUSIONS
  Bipolar patients smoke more than the general population. Bipolar patients that are moderate or heavy smokers are more likely than nonsmokers to consume alcohol and abuse psychoactive substances. Contrary to findings of previous studies, no association was found between clinical variables of bipolar patients and smoking.
authors.affiliation: Tirat Carmel Mental Health Center affiliated to Bruce Rappaport Faculty of Medicine, Technion, Haifa, Israel. kranata@gmail.com
authors.forename: Anatoly
authors.initials: A
authors.lastname: Kreinin
authors.forename: Dmitri
authors.initials: D
authors.lastname: Novitski
authors.forename: David
authors.initials: D
authors.lastname: Rabinowitz
authors.forename: Abraham
authors.initials: A
authors.lastname: Weizman
authors.forename: Alexander
authors.initials: A
authors.lastname: Grinshpoon
mesh_terms: D000328:Adult; D017668:Age of Onset; D000368:Aged; D001714:Bipolar Disorder / Q000453:epidemiology* / Q000523:psychology; D016009:Chi-Square Distribution; D015897:Comorbidity; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007406:Interview, Psychological; D007557:Israel / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D010045:Outpatients / Q000523:psychology / Q000706:statistics & numerical data; D015995:Prevalence; D012189:Retrospective Studies; D012907:Smoking / Q000453:epidemiology* / Q000523:psychology; D055815:Young Adult