title: Cigarette smoking in male patients with chronic schizophrenia in a Chinese population: prevalence and relationship to clinical phenotypes.
abstract: The high prevalence of smoking in schizophrenia of European background may be related to smoking's reducing clinical symptoms and medication side effects. Because smoking prevalence and its associations with clinical phenotypes are less well characterized in Chinese than European patients with schizophrenia, we assessed these smoking behaviors using clinician-administered questionnaires and the Fagerstrom Test for Nicotine Dependence (FTND) in 776 Chinese male schizophrenia and 560 control subjects. Patients also were rated on the Positive and Negative Symptom Scale (PANSS), the Simpson and Angus Extrapyramidal Symptom Rating Scale (SAES), and the Abnormal Involuntary Movement Scale (AIMS). We found that the schizophrenia patients had a higher lifetime incidence of smoking (79% vs 63%), were more likely to be heavy smokers (61% vs 31%), and had lower smoking cessation rates (4% vs 9%) (all p<0.0001) than controls. Among the schizophrenia patients smoking prevalence increased with age, with the largest difference from controls in the age cohort of 55-75 years: 75% vs 46% (p<0.0001). Among the schizophrenia smokers 73% started to smoke before the onset of their illness by an average of 7.6 years. The patients with schizophrenia who were current smokers scored significantly lower on the PANSS negative symptom subscore (p<0.005), and on the SAES symptom scale (p<0.04; Bonferroni corrected p>0.05) than the non-smoking patients. These results suggest that Chinese males with schizophrenia smoke more frequently than the general population. Further, smokers with schizophrenia may display fewer negative symptoms and possibly less parkinsonism than non-smokers with schizophrenia.
authors.affiliation: Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, Texas, United States of America. xyzhang@bcm.edu
authors.forename: Xiang Yang
authors.initials: XY
authors.lastname: Zhang
authors.forename: Jun
authors.initials: J
authors.lastname: Liang
authors.forename: Da Chun
authors.initials: DC
authors.lastname: Chen
authors.forename: Mei Hong
authors.initials: MH
authors.lastname: Xiu
authors.forename: Jincai
authors.initials: J
authors.lastname: He
authors.forename: Wei
authors.initials: W
authors.lastname: Cheng
authors.forename: Zhiwei
authors.initials: Z
authors.lastname: Wu
authors.forename: Fu De
authors.initials: FD
authors.lastname: Yang
authors.forename: Colin N
authors.initials: CN
authors.lastname: Haile
authors.forename: Hongqiang
authors.initials: H
authors.lastname: Sun
authors.forename: Lin
authors.initials: L
authors.lastname: Lu
authors.forename: Therese A
authors.initials: TA
authors.lastname: Kosten
authors.forename: Thomas R
authors.initials: TR
authors.lastname: Kosten
mesh_terms: D000367:Age Factors; D000368:Aged; D044466:Asian People; D016022:Case-Control Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010641:Phenotype; D015995:Prevalence; D012565:Schizophrenic Psychology; D012907:Smoking / Q000009:adverse effects*; D011795:Surveys and Questionnaires