title: Smoking status and its relationship to demographic and clinical characteristics in first episode psychosis.
abstract: Elevated rates of cigarette smoking are observed prior to the onset of psychosis and remain stable early in the illness. Cannabis use frequently co-occurs with cigarette smoking and is independently associated with distinct clinical outcomes. However, past research has not controlled for cannabis use in cigarette smokers with first episode psychosis (FEP), limiting conclusions on the unique relationship of cigarette smoking to the demographic and clinical profiles of these patients. The present study therefore aimed to: (1) Determine the prevalence and patterns of cigarette smoking and its co-use with cannabis in FEP, and (2) Examine the demographic, clinical, cognitive, and functional characteristics associated with cigarette smoking status, after adjusting for frequency of cannabis use. Patients entering specialized treatment for FEP (N = 140) were divided into groups according to their current smoking status: 66 non-smokers (0 cigarettes/day), 47 light/moderate smokers (1-19 cigarettes/day; M = 9.81, SD = 3.93), and 27 heavy smokers (≥20 cigarettes/day; M = 26.39, SD = 6.31). The prevalence of cigarette smoking was 53% and smoking status was highly associated with frequency of cannabis use. After adjusting for cannabis use, significant between-group differences emerged. Heavy smokers were older at program entry and had a later age of onset of psychosis than light/moderate and non-smokers. Non-smokers had more education, better neurocognitive performance, and higher levels of functioning than light/moderate and heavy smokers. Prospective, longitudinal studies are needed to better understand the clinical significance of tobacco use and factors that contribute to the initiation and continuation of smoking behaviours in FEP.
authors.affiliation: Department of Psychology, Queen's University, 62 Arch Street, Kingston, ON, K7L 3N6, Canada. Electronic address: michael.grossman@queensu.ca.
authors.forename: Michael
authors.initials: M
authors.lastname: Grossman
authors.affiliation: Department of Psychology, Queen's University, 62 Arch Street, Kingston, ON, K7L 3N6, Canada. Electronic address: bowiec@queensu.ca.
authors.forename: Christopher R
authors.initials: CR
authors.lastname: Bowie
authors.affiliation: Prevention and Early Intervention Program for Psychosis (PEPP-Montréal), Douglas Mental Health University Institute, 6875 Boulevard LaSalle, Verdun, QC, H4H 1R3, Canada; Department of Psychiatry, McGill University, 1033 Pine Avenue West, Montréal, QC, H3A 1A1, Canada. Electronic address: martin.lepage@mcgill.ca.
authors.forename: Martin
authors.initials: M
authors.lastname: Lepage
authors.affiliation: Prevention and Early Intervention Program for Psychosis (PEPP-Montréal), Douglas Mental Health University Institute, 6875 Boulevard LaSalle, Verdun, QC, H4H 1R3, Canada; ACCESS Open Minds (A Pan-Canadian Youth Mental Health Network), Douglas Mental Health University Institute, 6875 Boulevard LaSalle, Verdun, QC, H4H 1R3, Canada; Department of Psychiatry, McGill University, 1033 Pine Avenue West, Montréal, QC, H3A 1A1, Canada. Electronic address: ashok.malla@douglas.mcgill.ca.
authors.forename: Ashok K
authors.initials: AK
authors.lastname: Malla
authors.affiliation: Prevention and Early Intervention Program for Psychosis (PEPP-Montréal), Douglas Mental Health University Institute, 6875 Boulevard LaSalle, Verdun, QC, H4H 1R3, Canada; Department of Psychiatry, McGill University, 1033 Pine Avenue West, Montréal, QC, H3A 1A1, Canada. Electronic address: ridha.joober@douglas.mcgill.ca.
authors.forename: Ridha
authors.initials: R
authors.lastname: Joober
authors.affiliation: Prevention and Early Intervention Program for Psychosis (PEPP-Montréal), Douglas Mental Health University Institute, 6875 Boulevard LaSalle, Verdun, QC, H4H 1R3, Canada; ACCESS Open Minds (A Pan-Canadian Youth Mental Health Network), Douglas Mental Health University Institute, 6875 Boulevard LaSalle, Verdun, QC, H4H 1R3, Canada; Department of Psychiatry, McGill University, 1033 Pine Avenue West, Montréal, QC, H3A 1A1, Canada. Electronic address: srividya.iyer@douglas.mcgill.ca.
authors.forename: Srividya N
authors.initials: SN
authors.lastname: Iyer
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D017668:Age of Onset; D004522:Educational Status; D005260:Female; D006801:Humans; D007406:Interview, Psychological; D008297:Male; D002189:Marijuana Abuse / Q000150:complications / Q000453:epidemiology / Q000523:psychology; D009483:Neuropsychological Tests; D015995:Prevalence; D011446:Prospective Studies; D011618:Psychotic Disorders / Q000150:complications / Q000188:drug therapy / Q000453:epidemiology*; D011792:Quebec; D012720:Severity of Illness Index; D012907:Smoking / Q000453:epidemiology* / Q000523:psychology; D055815:Young Adult
keywords: Cannabis; Cognition; First episode psychosis; Smoking; Symptoms; Tobacco