TY - JOUR
T1 - The impact of cigarette smoking on life expectancy in schizophrenia, schizoaffective disorder and bipolar affective disorder: An electronic case register cohort study
AU - Chesney, Edward
AU - Robson, Deborah
AU - Patel, Rashmi
AU - Shetty, Hitesh
AU - Richardson, Sol
AU - Chang, Chin-Kuo
AU - McGuire, Philip
AU - McNeill, Ann
N1 - Funding Information:
EC is funded by a National Institute for Health Research Doctoral Research Fellowship ( NIHR300273 ).
Funding Information:
This research was supported by the Biomedical Research Nucleus data management and informatics facility at South London and Maudsley NHS Foundation Trust, which is funded by the National Institute for Health Research (NIHR) Mental Health Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King's College London and a joint infrastructure grant from Guy's and St Thomas' Charity and the Maudsley Charity.EC is funded by a National Institute for Health Research Doctoral Research Fellowship (NIHR300273).RP has received support from a Medical Research Council (MRC) Health Data Research UK Fellowship (MR/S003118/1) and a Starter Grant for Clinical Lecturers (SGL015/1020) supported by the Academy of Medical Sciences, The Wellcome Trust, MRC, British Heart Foundation, Arthritis Research UK, the Royal College of Physicians and Diabetes UK.C-KC was funded by the NIHR Specialist Biomedical Research Centre for Mental Health at the South London and Maudsley NHS Foundation Trust and Institute of Psychiatry, Psychology, and Neuroscience, King's College London. C-KC had received research funding from recent Roche cooperation (negative symptoms and the other dementia studies). No support from any other organisation for the submitted work and no other relationships or activities that could appear to have influenced the submitted work as declared.DR and AM are part funded by the NIHR Collaboration South London (NIHR ARC South London) at King's College Hospital NHS Foundation Trust. AM is an NIHR Senior Investigator. The views expressed are those of the authors] and not necessarily those of the NIHR or the Department of Health and Social Care.
Funding Information:
This research was supported by the Biomedical Research Nucleus data management and informatics facility at South London and Maudsley NHS Foundation Trust, which is funded by the National Institute for Health Research (NIHR) Mental Health Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King's College London and a joint infrastructure grant from Guy's and St Thomas' Charity and the Maudsley Charity .
Funding Information:
RP has received support from a Medical Research Council (MRC) Health Data Research UK Fellowship ( MR/S003118/1 ) and a Starter Grant for Clinical Lecturers ( SGL015/1020 ) supported by the Academy of Medical Sciences , The Wellcome Trust , MRC , British Heart Foundation , Arthritis Research UK , the Royal College of Physicians and Diabetes UK .
Funding Information:
DR and AM are part funded by the NIHR Collaboration South London (NIHR ARC South London) at King's College Hospital NHS Foundation Trust. AM is an NIHR Senior Investigator. The views expressed are those of the authors] and not necessarily those of the NIHR or the Department of Health and Social Care.
Funding Information:
C-KC was funded by the NIHR Specialist Biomedical Research Centre for Mental Health at the South London and Maudsley NHS Foundation Trust and Institute of Psychiatry, Psychology, and Neuroscience, King's College London . C-KC had received research funding from recent Roche cooperation (negative symptoms and the other dementia studies). No support from any other organisation for the submitted work and no other relationships or activities that could appear to have influenced the submitted work as declared.
Publisher Copyright:
© 2018
PY - 2021/9/23
Y1 - 2021/9/23
N2 - Severe mental disorders are associated with a life expectancy that is 10–20 years shorter than the general population's. The prevalence of cigarette smoking in these populations is very high. We examined the effect of smoking on life expectancy and survival in patients with a diagnosis of schizophrenia, schizoaffective disorder or bipolar affective disorder from 2007 to 2018 in South East London, UK. Smoking status was determined using unstructured text data extracted from electronic health records. A total of 21,588 patients were identified of which 16,717, (77.4%) were classified as current smokers and 3438 (15.9%) as non-smokers. In female participants, life expectancy at birth was 67.6 years in current smokers (95% CI: 66.4–68.8) and 74.9 years in non-smokers (95% CI: 72.8–77.0), a difference of 7.3 years. In male participants, life expectancy at birth was 63.5 years in current smokers (95% CI: 62.5–64.5) and 68.5 years in non-smokers (95% CI, 64.4–72.6), a difference of 5.0 years. Adjusted survival models found that current smoking status was associated with an increased mortality risk for both females (aHR: 1.42, 95% CI: 1.21–1.66, p < 0.001) and males (aHR: 1.49; 95% CI: 1.25–1.79, p < 0.001). In terms of the effect sizes, these risks were similar to those associated with a diagnosis of co-morbid alcohol or opioid use disorder. Smoking may account for a substantial proportion of the reduced life expectancy in patients with psychotic disorders. Increased emphasis on reducing cigarette smoking in these populations may be the most effective way to reduce the mortality gap with the general population.
AB - Severe mental disorders are associated with a life expectancy that is 10–20 years shorter than the general population's. The prevalence of cigarette smoking in these populations is very high. We examined the effect of smoking on life expectancy and survival in patients with a diagnosis of schizophrenia, schizoaffective disorder or bipolar affective disorder from 2007 to 2018 in South East London, UK. Smoking status was determined using unstructured text data extracted from electronic health records. A total of 21,588 patients were identified of which 16,717, (77.4%) were classified as current smokers and 3438 (15.9%) as non-smokers. In female participants, life expectancy at birth was 67.6 years in current smokers (95% CI: 66.4–68.8) and 74.9 years in non-smokers (95% CI: 72.8–77.0), a difference of 7.3 years. In male participants, life expectancy at birth was 63.5 years in current smokers (95% CI: 62.5–64.5) and 68.5 years in non-smokers (95% CI, 64.4–72.6), a difference of 5.0 years. Adjusted survival models found that current smoking status was associated with an increased mortality risk for both females (aHR: 1.42, 95% CI: 1.21–1.66, p < 0.001) and males (aHR: 1.49; 95% CI: 1.25–1.79, p < 0.001). In terms of the effect sizes, these risks were similar to those associated with a diagnosis of co-morbid alcohol or opioid use disorder. Smoking may account for a substantial proportion of the reduced life expectancy in patients with psychotic disorders. Increased emphasis on reducing cigarette smoking in these populations may be the most effective way to reduce the mortality gap with the general population.
UR - http://www.scopus.com/inward/record.url?scp=85115411600&partnerID=8YFLogxK
U2 - 10.1016/j.schres.2021.09.006
DO - 10.1016/j.schres.2021.09.006
M3 - Article
SN - 0920-9964
VL - 238
SP - 29
EP - 35
JO - Schizophrenia Research
JF - Schizophrenia Research
ER -
