Impact of smoking behavior on cognitive functioning in persons at risk for psychosis and healthy controls: A longitudinal study
Open Access
- 21 September 2021
- journal article
- research article
- Published by Royal College of Psychiatrists in European Psychiatry
- Vol. 64 (1), 1-20
- https://doi.org/10.1192/j.eurpsy.2021.2233
Abstract
Background The high prevalence of smoking in individuals who are at ultra-high risk (UHR) for psychosis is well known and moderate cognitive deficits have also been found in UHR. However, the association between smoking and cognition in UHR is unknown and longitudinal studies are lacking. Method A cohort study with 330 UHR individuals and 66 controls was conducted, as part of the European network of national schizophrenia networks studying gene-environment interactions (EU-GEI). At baseline and after 6, 12, and 24 months, smoking behavior was assessed with the Composite International Diagnostic Interview and cognitive functioning with a comprehensive test battery. Linear mixed-effects analyses were used to examine the multicross-sectional and prospective associations between (change in) smoking behavior and cognitive functioning, accounting for confounding variables. Results At baseline, 53% of UHR and 27% of controls smoked tobacco. Smoking UHR and controls did not significantly differ from nonsmoking counterparts on the tested cognitive domains (speed of processing, attention/vigilance, working memory, verbal learning, or reasoning/problem solving) across different assessment times. Neither smoking cessation nor initiation was associated with a significant change in cognitive functioning in UHR. Conclusions No associations were found between smoking and cognitive impairment in UHR nor in controls. However, the fact that one in every two UHR individuals report daily use of tobacco is alarming. Our data suggest that UHR have fewer cognitive impairments and higher smoking cessation rates compared to patients with first-episode psychosis found in literature. Implications to promote smoking cessation in the UHR stage need further investigation.Keywords
This publication has 60 references indexed in Scilit:
- Impact of Smoking on Cognitive Decline in Early Old AgeArchives of General Psychiatry, 2012
- Startle reactivity and prepulse inhibition in prodromal and early psychosis: Effects of age, antipsychotics, tobacco and cannabis in a vulnerable populationPsychiatry Research, 2011
- Meta-analysis of the acute effects of nicotine and smoking on human performancePsychopharmacology, 2010
- Progression of Cerebral Small Vessel Disease in Relation to Risk Factors and Cognitive ConsequencesStroke, 2008
- Course of substance misuse and daily tobacco use in first-episode psychosisSchizophrenia Research, 2006
- A meta-analysis of worldwide studies demonstrates an association between schizophrenia and tobacco smoking behaviorsSchizophrenia Research, 2005
- Trail Making Test A and B: Normative data stratified by age and educationArchives of Clinical Neuropsychology, 2004
- The Reliability of the CIDI‐SAM: a comprehensive substance abuse interviewBritish Journal of Addiction, 1989
- A Test of Missing Completely at Random for Multivariate Data with Missing ValuesJournal of the American Statistical Association, 1988
- Learning and Retrieval Rate of Words Presented Auditorily and VisuallyThe Journal of General Psychology, 1985