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Tobacco smoking is associated with psychotic experiences in the general population of South London

Research output: Contribution to journalArticle

Original languageEnglish
Pages (from-to)1-9
Number of pages9
JournalPsychological Medicine
Early online date28 Jun 2017
Publication statusE-pub ahead of print - 28 Jun 2017


  • Tobacco smoking is associated_BHAVSAR_Accepted11May2017_GREEN AAM

    Tobacco_smoking_is_associated_BHAVSAR_Accepted11May2017_GREEN_AAM.pdf, 528 KB, application/pdf


    Accepted author manuscript


    This article has been published in a revised form in Psychological Medicine, at 10.1017/S0033291717001556. This version is free to view and download for private research and study only. Not for re-distribution, re-sale or use in derivative works. © Cambridge University Press 2017

King's Authors


Background: The association between cigarette smoking and psychosis remains unexplained, but could relate to causal effects in both directions, confounding by socioeconomic factors, such as ethnicity, or use of other substances, including cannabis. Few studies have evaluated the association between cigarettes and psychotic experiences (PEs) in diverse, inner-city populations, or relationships with number of cigarettes consumed. 

Methods: We assessed associations and dose–response relationships between cigarette smoking and PEs in a cross-sectional survey of household residents (n = 1680) in South East London, using logistic regression to adjust for cannabis use, other illicit substances, and socioeconomic factors, including ethnicity. 

Results: We found association between any PEs and daily cigarette smoking, which remained following adjustment for age, gender, ethnicity, cannabis and use of illicit stimulant drugs (fully adjusted odds ratio 1.47, 95% confidence interval 1.01–2.15). Fully adjusted estimates for the association, and with number of PEs, increased with number of cigarettes smoked daily, implying a dose–response effect (p = 0.001 and <0.001, respectively). Odds of reporting any PEs in ex-smokers were similar to never-smokers. 

Conclusions: In this diverse epidemiological sample, association between smoking and PEs was not explained by confounders such as cannabis or illicit drugs. Daily cigarette consumption showed a dose–response relationship with the odds of reporting PEs, and of reporting a greater number of PEs. There was no difference in odds of reporting PEs between ex-smokers and never-smokers, raising the possibility that the increase in PEs associated with smoking may be reversible.

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