Tobacco associated with new mental illness in prospective study.

Posted: September 13, 2007 22:31

Smoking is associated with first-ever incidence of mental disorders: a prospective population-based study. Cuijpers P, Smit F, ten Have M, de Graaf R.

For the first time, I believe, the intrepid Dutch group (NEMESIS or Netherlands Mental Health Survey and Incidence Study) has found a significant association between tobacco smoking and mental illness. With up to 80% response rates in over 5000 Dutch adults this study looked at who was smoking and/or had a mental illness at the start, one and three years (along with many other variables).

A significant association found was between smoking and the development of anxiety, dysthymia and new alcohol abuse. Unlike cannabis, no association was found with psychosis. Considering the prevalence of smoking the findings are still highly significant. The prospective nature and accounting for confounders in these findings supports a causal association from the tobacco, yet no dose relation was found. Hence further research will need to look at these areas, according to the authors. Also, a rational pathogenic pathway from smoking to mental disease needs to be confirmed. It may not be a coincidence that some mental illness is increasing in extent and severity in certain countries.

Two other recent studies have apparently shown links between smoking and dementia (Holland; ANU). The Erasmus Medical Centre in Holland found a 50% increase in dementia in age matched smokers. The links with lung cancer and arterial disease are well known.

So the ground-swell against tobacco continues, based on its being the largest single reversible cause of death and morbidity in our society. Countless deaths each year are attributed to tobacco related diseases.  While we know how to treat established nicotine addiction, we still do not know why people smoke and whether there are safer pharmaceutical alternatives and when these may be appropriate. 

Comments by Andrew Byrne Dr Byrne and colleagues have written summaries of many research articles, conferences and other events. These have been written largely to draw attention to peer-reviewed studies which may be relevant to clinical practice and public policy. While all care has been taken to be fair and accurate, readers are strongly advised to read the original publications before acting upon the information for clinical decisions.

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