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Smoking is associated with an increased risk of death in people aged 35–54 with schizophrenia

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Is the risk of mortality higher in people with schizophrenia who smoke cigarettes compared with those who are non-smokers?


1213 adults (19–69 years), admitted to inpatient mental health facilities between 1994 and 2000 for schizophrenia (53.7%), schizoaffective disorder (33.6%) or psychosis (12.7%) as defined by DSM-III and IV. Only first admissions, and those with recorded information on smoking were considered for inclusion; people treated only with first generation antipsychotics or no antipsychotic at the time of admission were excluded.


Seven public inpatient mental health hospitals in Maryland, Baltimore, USA; 1994 to 2004.

Prognostic factors

Smoking status (ie, smoker or non-smoker); severity of smoking (ie, ≥1 or <1 pack per day), age and gender. Among the participants, 664 (54.7%) smoked and 549 (45.3%) were non-smokers. Smokers were defined as anyone who smoked cigarettes on admission or who had a history of dependence on cigarettes. Researchers reviewed clinical records to collect data on DSM-IV diagnoses, smoking status, substance use and comorbid conditions. Analyses were adjusted for age, gender, race and antipsychotic treatment.


Death from any cause between 1994 and 2004, identified by matching patient records with the Social Security Death Index national database, …

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  • Sources of funding National Institutes of Health, Advanced Centres for intervention and Services Research.


  • Competing interests None.

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