Cigarette smoking is highly prevalent among people with bipolar disorder or schizophrenia. Few studies have examined whether smoking history is associated with adaptive functioning among individuals diagnosed with these serious mental illnesses.
In a large relatively homogenous cohort of patients with either bipolar disorder (n=363) or schizophrenia (n=400), we investigated the association between cigarette smoking status, intensity, and cumulative exposure and performance on a comprehensive battery of neurocognitive, functional capacity, informant-rated functional measures. The associations were adjusted for variation in sociodemographic indicators, psychopathologic symptoms, and substance use.
There was an average of 12 pack years of smoking across the sample. People with schizophrenia reported double the rate of current smoking compared to patients with bipolar disorder. Adjusting for demographic covariates, current smokers had worse composite cognitive functioning and poorer functional outcome than past or never smokers. There were no significant differences between never and past smokers, and these effects were evident in both bipolar disorder and schizophrenia.
Current smokers with either schizophrenia or bipolar disorder evidence worse cognitive and adaptive functioning functional outcome, even when demographic covariates are considered.
Patients with schizophrenia had double the rate of smoking compared to patients with bipolar disorder
Current smoking was negatively associated with cognitive functioning, functional capacity, and informant reported functional outcomes in both patients with schizophrenia and bipolar disorder, after adjusting for sociodemographic covariates
The study was cross-sectional and so causal associations cannot be inferred
Tobacco use was assessed with a self-report instrument
The sample was relatively homogenous and high function and may not generalize to ethnically diverse or more symptomatic samples