Tobacco Smoking and Bipolar Disorder
J Clin Psychiatry 1998;59:225-228
© Copyright 2014 Physicians Postgraduate Press, Inc.
Purchase This PDF for $40.00
If you are not a paid subscriber, you may purchase the PDF.
(You'll need the free Adobe Acrobat Reader.)
Receive immediate full-text access to JCP. You can subscribe to JCP online-only ($86) or print + online ($156 individual).
With your subscription, receive a free PDF collection of the NCDEU Festschrift articles. Hurry! This offer ends December 31, 2011.
If you are a paid subscriber to JCP and do not yet have a username and password, activate your subscription now.
As a paid subscriber who has activated your subscription, you have access to the HTML and PDF versions of this item.
Click here to login.
Did you forget your password?
Still can't log in? Contact the Circulation Department at 1-800-489-1001 x4 or send email
Background: We sought to determine whether
tobacco smoking is associated with bipolar
Method: This case-control study carried out in
Alava, in the north of Spain, included patients with a DSM-III-R
diagnosis of bipolar disorder type I (N=51) and a representative
sample of the normal population (N=517). Smoking history of
bipolar patients was assessed with the Fagerstrom Test for
Nicotine Dependence and was verified by family members of the
Results: The frequencies of ever smoking and
current daily smoking were, respectively, 63% (32/51) and 51%
(26/51) for the bipolar patients and 45% (235/517) and 33%
(169/517) for the control group (respective odds ratios [ORs] and
95% confidence intervals [CIs] were OR=2.0, 95% CI=1.1 to 3.8 and
OR=2.1, 95% CI=1.2 to 4.0). The differences were significant
(p=.03 and p=.042, respectively) for bipolar versus control
males. Bipolar disorder (in both genders) was also significantly
associated (OR=4.4, 95% CI=1.7 to 11.9, p=.0015) with heavy
smoking (more than 1 pack per day).
Conclusion: Despite its small sample size, this
study suggests that smoking may be more prevalent in bipolar
patients than in the normal population. Since most patients
started to smoke before the onset of illness, vulnerability to
bipolar illness may make subjects vulnerable to become tobacco