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Research Paper

Is initiation of smoking associated with the prodromal phase of schizophrenia?

Kaisa Riala, Helinä Hakko, Matti Isohanni, Anneli Pouta and Pirkko Räsänen
J Psychiatry Neurosci January 01, 2005 30 (1) 26-32;
Kaisa Riala
Riala, Hakko, Isohanni, Räsänen — Department of Psychiatry; Pouta — Department of Public Health Science and General Practice and Department of Obstetrics and Gynecology, University of Oulu, Finland
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Helinä Hakko
Riala, Hakko, Isohanni, Räsänen — Department of Psychiatry; Pouta — Department of Public Health Science and General Practice and Department of Obstetrics and Gynecology, University of Oulu, Finland
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Matti Isohanni
Riala, Hakko, Isohanni, Räsänen — Department of Psychiatry; Pouta — Department of Public Health Science and General Practice and Department of Obstetrics and Gynecology, University of Oulu, Finland
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Anneli Pouta
Riala, Hakko, Isohanni, Räsänen — Department of Psychiatry; Pouta — Department of Public Health Science and General Practice and Department of Obstetrics and Gynecology, University of Oulu, Finland
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Pirkko Räsänen
Riala, Hakko, Isohanni, Räsänen — Department of Psychiatry; Pouta — Department of Public Health Science and General Practice and Department of Obstetrics and Gynecology, University of Oulu, Finland
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    Fig. 1

    Age of initiation of regular smoking and age of onset of mental disorder among healthy controls and subjects with schizophrenia, other psychoses or nonpsychotic disorders in the Northern Finland 1966 Birth Cohort. Medians are indicated by horizontal bars inside the boxes. Vertical lines indicate the range, and the horizontal bars at each end of the boxes represent the first (25%) and third (75%) quartiles. The p values indicate the statistical significance, when the mean difference between ages of regular smoking and mental disorder for patients with schizophrenia is compared with that for subjects with other psychoses or nonpsychotic disorders.

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    Table 1

    Age of initiation of regular smoking and age of onset of psychiatric disorder among men and women according to diagnostic subgroup in the Northern Finland 1966 Birth Cohort

    Diagnostic groupTotal (n = 10 934)Subjects for whom data about smoking were available (n = 8324)
    No.Mean age of onset of disorder (and SD), yrNo.No. of smokers†Mean age of onset of disorder (and SD), yrMean age of initiation of regular smoking (and SD), yrMean difference between ages of onset (and SD), yr‡p value§
    Men
     Healthy control subjects*5276—38271318—17.7 (4.0)——
     Schizophrenia6522.2 (3.9)402220.9 (3.4)18.8 (4.5)2.2 (6.5)Ref
     Other psychoses2624.1 (4.6)19924.7 (4.3)16.0 (4.4)8.7 (7.9)0.015
     Nonpsychotic disorders22223.3 (4.1)1126323.7 (4.1)15.9 (3.8)7.8 (4.7)< 0.001
    Women
     Healthy control subjects*5188—4214925—18.5 (4.2)——
     Schizophrenia3522.1 (4.1)27823.9 (3.3)21.2 (5.7)2.6 (6.2)Ref
     Other psychoses2925.7 (4.3)20925.8 (4.8)17.3 (4.4)8.4 (4.7)0.13
     Nonpsychotic disorders9324.6 (4.6)652523.4 (5.1)19.9 (5.7)3.5 (5.9)0.94
    • Note: SD = standard deviation.

    • ↵* These subjects had no psychiatric disorder.

    • ↵† Not included in this column are smokers for whom the age of onset of smoking was missing, namely, 2 female subjects with schizophrenia, 5 men and 5 women with nonpsychotic disorders and 58 men and 68 women without psychiatric hospital treatment.

    • ↵‡ Mean difference (and SD) between age of onset of psychiatric disorder and age of onset of regular smoking.

    • ↵§ Analysis of variance with Scheffé’s multiple comparison test: comparison of mean difference in ages of onset between subjects with schizophrenia (ref) and other diagnostic groups among smokers.

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    Table 2

    Univariate association of family and environmental background factors, measured at the age of 14 years, with likelihood of regular smoking in adulthood among subjects with schizophrenia from the Northern Finland 1966 Birth Cohort

    Family and environmental background factorNo. (and %) of smokersNo. (and %) of nonsmokersOR (and 95% CI)p value¶
    Male22 (69)18 (51)2.1 (0.8–5.6)0.15
    One-parent family*10 (31)7 (20)1.8 (0.6–5.5)0.29
    Father’s socioeconomic status lowest (III–IV)†19 (59)17 (49)1.3 (0.5–3.9)0.59
    Father’s socioeconomic status, farmer3 (9)6 (17)0.6 (0.1–3.0)0.54
    School performance, not in age-appropriate class‡7 (22)4 (11)2.2 (0.6–8.3)0.26
    Own alcohol use at experimental level§16 (59)20 (69)0.7 (0.2–2.0)0.45
    Father smoking in home environment14 (50)6 (22)3.5 (1.9–11.3)0.035
    • Note: CI = confidence interval; OR = odds ratio.

    • ↵* One-parent families v. 2-parent families between 1966 and 1980.

    • ↵† Socioeconomic status in 1980 (I–II [highest social standing/professional status] v. III–IV [skilled and unskilled workers, respectively] v. V = farmers).

    • ↵‡ School performance at the age of 14 years categorized into 2 classes: not in age-appropriate class v. in age-appropriate class.

    • ↵§ Information based on a questionnaire mailed to cohort members at the age of 14 years.

    • ↵¶ χ2 test.

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Journal of Psychiatry and Neuroscience: 30 (1)
J Psychiatry Neurosci
Vol. 30, Issue 1
1 Jan 2005
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Is initiation of smoking associated with the prodromal phase of schizophrenia?
Kaisa Riala, Helinä Hakko, Matti Isohanni, Anneli Pouta, Pirkko Räsänen
J Psychiatry Neurosci Jan 2005, 30 (1) 26-32;

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Is initiation of smoking associated with the prodromal phase of schizophrenia?
Kaisa Riala, Helinä Hakko, Matti Isohanni, Anneli Pouta, Pirkko Räsänen
J Psychiatry Neurosci Jan 2005, 30 (1) 26-32;
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