title: The association between smoking prevalence and eating disorders: a systematic review and meta-analysis.
abstract: Cigarette smoking is associated with severe mental illness, including schizophrenia and bipolar disorder, and with morbidity and mortality, but the association with anorexia (AN), bulimia nervosa (BN) and binge eating disorder (BED) is unclear. This meta-analysis compared the odds of smoking in eating disorders (ED) (ED = AN or BN or BED) versus healthy controls (HC) and calculated the prevalence of smokers in people with ED.
  
  
  
  Three independent authors searched PubMed, MEDLINE and Scopus from database inception until 31 December 2015 for studies reporting data on life-time or current smoking prevalence in BED, BN and AN with or without control group. Meta-analyses were undertaken, calculating odds ratios (ORs) of life-time smoking in BED, BN, AN versus healthy controls (HCs) or prevalence of smoking in BED, BN and AN with 95% confidence intervals (CI).
  
  
  
  Thirty-one studies (ED = 8517, controls = 68 335) were meta-analysed. Compared with HCs, there were significantly more smokers among people with BN (life-time OR = 2.165) and BED (life-time OR = 1.792) but not AN (life-time OR = 0.927). BED was associated with smoking the most (life-time prevalence = 47.73%) followed by BN (life-time prevalence = 39.4%) and AN (life-time prevalence = 30.8%). In BN, life-time smoking prevalence was highest in Europe. In AN, higher age moderated both life-time and current smoking prevalence, and body mass index moderated higher life-time smoking prevalence. In BN, female sex moderated higher life-time smoking prevalence.
  
  
  
  People with binge eating disorder and bulimia nervosa are significantly more likely to be life-time smokers than healthy controls, which is not the case for anorexia nervosa.
authors.affiliation: Department of Neurosciences, University of Padova, Padova, Italy.|Local Health Unit ULSS 17, Mental Health Department, Monselice, Padova, Italy.|Institute of Clinical Research, and Education in Medicine (IREM), Padova, Italy.
authors.forename: Marco
authors.identifier: 0000-0003-4877-7233
authors.initials: M
authors.lastname: Solmi
authors.affiliation: Department of Medicine, DIMED, University of Padua, Padova, Italy.|Institute of Clinical Research, and Education in Medicine (IREM), Padova, Italy.
authors.forename: Nicola
authors.initials: N
authors.lastname: Veronese
authors.affiliation: Department of Medicine, DIMED, University of Padua, Padova, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Sergi
authors.affiliation: Department of Pathology and Diagnostics, Verona University and Hospital Trust, Verona, Italy.
authors.forename: Claudio
authors.initials: C
authors.lastname: Luchini
authors.affiliation: Department of Neurosciences, University of Padova, Padova, Italy.
authors.forename: Angela
authors.initials: A
authors.lastname: Favaro
authors.affiliation: Department of Neurosciences, University of Padova, Padova, Italy.
authors.forename: Paolo
authors.initials: P
authors.lastname: Santonastaso
authors.affiliation: University of Leuven, KU Leuven Department of Rehabilitation Sciences, Leuven, Belgium.|University of Leuven-KU Leuven, University Psychiatric Centre, Kortenberg-, Leuven, Belgium.
authors.forename: Davy
authors.initials: D
authors.lastname: Vancampfort
authors.affiliation: The Zucker Hillside Hospital, Psychiatry Research, Northwell Health System, Glen Oaks, New York, USA.|Hofstra Northwell School of Medicine, Hempstead, New York, USA.|The Feinstein Institute for Medical Research, Manhasset, New York, USA.|Albert Einstein College of Medicine, Bronx, New York, USA.
authors.forename: Christoph U
authors.initials: CU
authors.lastname: Correll
authors.affiliation: Population Health Research Institute, St George's University of London, London, UK.
authors.forename: Michael
authors.initials: M
authors.lastname: Ussher
authors.affiliation: KaskiSewa Hospital and Research Centre, Pokhara, Nepal.
authors.forename: Nita
authors.initials: N
authors.lastname: Thapa-Chhetri
authors.affiliation: New York Psychiatric Institute, Columbia University, NYC, USA.
authors.forename: Michele
authors.initials: M
authors.lastname: Fornaro
authors.affiliation: Physiotherapy Department, South London and Maudsley NHS Foundation Trust, Denmark Hill, London, SE5 8AZ, UK. brendon.stubbs@kcl.ac.uk.|Health Service and Population Research Department, Institute of Psychiatry, King's College, London, De Crespigny Park, London, UK. brendon.stubbs@kcl.ac.uk.
authors.forename: Brendon
authors.initials: B
authors.lastname: Stubbs
mesh_terms: D000328:Adult; D000073865:Cigarette Smoking / Q000009:adverse effects / Q000453:epidemiology*; D001068:Feeding and Eating Disorders / Q000453:epidemiology* / Q000209:etiology; D005260:Female; D064368:Healthy Volunteers; D006801:Humans; D008297:Male; D015995:Prevalence; D012044:Regression Analysis; D012737:Sex Factors; D055815:Young Adult
keywords: Anorexia nervosa; binge eating disorder; bulimia nervosa; eating disorders; meta-analysis; moderators; smoking