Physical and mental health burden in cases of bipolar disorder classified as current, former, or non-tobacco smokers.
Tobacco smoking increases the global burden of bipolar disorder (BD). We examined markers of physical and mental health that are associated with tobacco smoking, controlling for confounders that have not always been considered in previous studies of BD.



Over 600 individuals with BD I or II referred to the French Network for bipolar disorder (FACE-BD) who completed standardized assessments, and could be reliably classified as current (CS) or former smokers (FS), were compared with those who were never smokers (NS) on: BD symptom load and psychiatric comorbidities; prevalence of alcohol and substance use disorders (ASUD); medication usage; functioning and physical health parameters. The bivariate and multivariate analyses took into account age and gender.



300 cases (49%) were CS, 78 (13%) FS and 238 (39%) had never smoked. Rates were similar across genders regardless of BD subtype. Compared with NS, CS were more likely to have an ASUD (Odds Ratio (OR) 5.18), BD I (OR 2.09), and lower abdominal obesity (OR 0.97), and FS were more likely to have an ASUD (OR 6.32) and higher abdominal obesity (OR 1.03).



The sample comprised of white Europeans; the FS subgroup was relatively small and we did not apply any statistical correction for the bivariate analyses.



The increased risk of physical and mental health burden in CS and FS compared to NS represents avoidable morbidity in BD. This study offers support to the argument that individuals with BD should be routinely offered support to prevent or stop tobacco smoking.
FondaMental Foundation, F-94000 Créteil, France; Paris Diderot Univeristy, Inserm UMR-S 1144, Paris F-75013, France; Paris Descartes University, Inserm UMR-S1144, Paris F-75006, France; Inserm U 1144, F-75006 Paris, France; Assistance Publique - Hôpitaux de Paris, GH Saint-Louis - Lariboisière - F. Widal, Department of Psychiatry and Addiction Medicine, Paris F-75010, France. Electronic address: romain.icick@aphp.fr.
R
R
Icick
FondaMental Foundation, F-94000 Créteil, France; CH Charles Perrens, F-33076 Bordeaux, France.
S
S
Gard
FondaMental Foundation, F-94000 Créteil, France; Assistance Publique - Hôpitaux de Paris, GH Saint-Louis - Lariboisière - F. Widal, Department of Psychiatry and Addiction Medicine, Paris F-75010, France.
M
M
Barde
FondaMental Foundation, F-94000 Créteil, France; Assistance Publique - Hôpitaux de Paris, GH Saint-Louis - Lariboisière - F. Widal, Department of Psychiatry and Addiction Medicine, Paris F-75010, France.
M
M
Carminati
CH Charles Perrens, F-33076 Bordeaux, France.
A
A
Desage
FondaMental Foundation, F-94000 Créteil, France; Montpellier 1 University, Inserm U1061, Montpellier, France; CH Lapeyronie, F-34000, Montpellier, France.
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S
Guillaume
Academic Psychiatry, Institute of Neuroscience, Newcastle University, Newcastle, UK; Centre for Affective Disorders, IPPN, London, UK.
J
J
Scott
FondaMental Foundation, F-94000 Créteil, France; Paris Diderot Univeristy, Inserm UMR-S 1144, Paris F-75013, France; Paris Descartes University, Inserm UMR-S1144, Paris F-75006, France; Inserm U 1144, F-75006 Paris, France; Assistance Publique - Hôpitaux de Paris, GH Saint-Louis - Lariboisière - F. Widal, Department of Psychiatry and Addiction Medicine, Paris F-75010, France.
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F
Bellivier
D000328:Adult; D015415:Biomarkers / Q000032:analysis; D001714:Bipolar Disorder / Q000150:complications* / Q000503:physiopathology / Q000523:psychology; D005260:Female; D006801:Humans; D008297:Male; D008603:Mental Health; D008875:Middle Aged; D015995:Prevalence; D012306:Risk; D000074285:Smokers / Q000523:psychology*; D000073869:Tobacco Smoking / Q000009:adverse effects*
D015415:Biomarkers
Alcohol and substance use disorder; Bipolar disorder; Comorbidity; Gender; Physical health; Tobacco smoking