A prospective study of the impact of smoking on outcomes in bipolar and schizoaffective disorder

Compr Psychiatry. Sep-Oct 2010;51(5):504-9. doi: 10.1016/j.comppsych.2009.12.001. Epub 2010 Feb 19.


Background: Tobacco smoking is more prevalent among people with mental illnesses, including bipolar disorder, than in the general community. Most data are cross-sectional, and there are no prospective trials examining the relationship of smoking to outcome in bipolar disorder. The impact of tobacco smoking on mental health outcomes was investigated in a 24-month, naturalistic, longitudinal study of 240 people with bipolar disorder or schizoaffective disorder.

Method: Participants were interviewed and data recorded by trained study clinicians at 9 interviews during the study period.

Results: Comparisons were made between participants who smoked daily (n = 122) and the remaining study participants (n = 117). During the 24-month study period, the daily smokers had poorer scores on the Clinical Global Impressions-Depression (P = .034) and Clinical Global Impressions-Overall Bipolar (P = .026) scales and had lengthier stays in hospital (P = .012), compared with nonsmokers.

Limitations: Smoking status was determined by self-report. Nicotine dependence was not measured.

Conclusion: These findings suggest that smoking is associated with poorer mental health outcomes in bipolar and schizoaffective disorder.

Publication types

  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Age of Onset
  • Bipolar Disorder / epidemiology
  • Bipolar Disorder / therapy*
  • Case-Control Studies
  • Comorbidity
  • Female
  • Humans
  • Least-Squares Analysis
  • Male
  • Prevalence
  • Prospective Studies
  • Psychotic Disorders / epidemiology
  • Psychotic Disorders / therapy*
  • Smoking / epidemiology*
  • Treatment Outcome
  • Victoria / epidemiology