title: Psychotic symptoms and smoking in 44 countries.
abstract: To assess the association between psychotic symptoms and smoking among community-dwelling adults in 44 countries.
  
  
  
  Data from the World Health Survey (WHS) for 192 474 adults aged ≥18 years collected in 2002-2004 were analyzed. The Composite International Diagnostic Interview was used to identify four types of past 12-month psychotic symptoms. Smoking referred to current daily and non-daily smoking. Heavy smoking was defined as smoking ≥30 tobacco products/day.
  
  
  
  The pooled age-sex-adjusted OR (95% CI) of psychotic symptoms (i.e., at least one psychotic symptom) for smoking was 1.35 (1.27-1.43). After adjustment for potential confounders, compared to those with no psychotic symptoms, the ORs (95% CIs) for smoking for 1, 2, and ≥3 psychotic symptoms were 1.20 (1.08-1.32), 1.25 (1.08-1.45), and 1.36 (1.13-1.64) respectively. Among daily smokers, psychotic symptoms were associated with heavy smoking (OR = 1.45, 95% CI = 1.10-1.92), and individuals who initiated daily smoking at ≤15 years of age were 1.22 (95% CI = 1.05-1.42) times more likely to have psychotic symptoms.
  
  
  
  An increased awareness that psychotic symptoms are associated with smoking is important from a public health and clinical point of view. Future studies that investigate the underlying link between psychotic symptoms and smoking prospectively are warranted.
authors.affiliation: Parc Sanitari Sant Joan de Déu, Universitat de Barcelona, Fundació Sant Joan de Déu, Barcelona, Spain.|Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain.
authors.forename: A
authors.initials: A
authors.lastname: Koyanagi
authors.affiliation: The Stockholm Centre for Health and Social Change (SCOHOST), Södertörn University, Huddinge, Sweden.
authors.forename: A
authors.initials: A
authors.lastname: Stickley
authors.affiliation: Parc Sanitari Sant Joan de Déu, Universitat de Barcelona, Fundació Sant Joan de Déu, Barcelona, Spain.|Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain.
authors.forename: J M
authors.initials: JM
authors.lastname: Haro
mesh_terms: D000328:Adult; D005260:Female; D014943:Global Health; D006306:Health Surveys; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011618:Psychotic Disorders / Q000453:epidemiology*; D012907:Smoking / Q000453:epidemiology*; D055815:Young Adult
keywords: epidemiology; low- and middle-income countries; population-based; psychosis; psychotic experience; tobacco