Smoking and mental health - NCSCT

Epidemiology of the association between smoking and mental disorders 4
Relative risk (RR)
Relative risk (RR)
Study or subgroup IV, random, 95% Cl IV, random, 95% Cl
Blase 2009 1.53 [1.36, 1.72]
Brook 2008 1.21 [0.81, 1.81]
Burke 2001 2.21 [0.99, 4.92]
Elkins 2007 2.01 [1.23, 3.28]
Rohde 2004 3.83 [1.83, 8.04]
Total (95% CI) 1.75 [1.31, 2.34]
Heterogeneity, tau 2 = 0.05; chi 2 = 9.04, df = 4 (p = 0.06); I 2 = 56%
Test for overall effect: Z = 3.81 (p = 0.0001)
0.2 0.5
ADHD reduces risk
1
2 5
ADHD increases risk
Fig 4.2 Attention deficit hyperactivity disorder (ADHD) and the onset of
smoking.
initiation (RR = 1.07, 95% CI 0.91–1.26, I 2 = 71%, three studies); 11,12,15 however,
smoking initiation was significantly increased in those with inattention (RR =
1.23, 95% CI 1.06–1.44, I 2 = 69%, three studies), 11–13 and particularly so in those
with both inattention and hyperactivity (RR = 2.64, 95% CI 1.48–4.72). 13 There
was some evidence to suggest that hyperactivity alone may be associated with
smoking initiation (RR = 1.63, 95% CI 0.95–2.81, I 2 = 77%, three studies), 13,19,25
onset of daily/regular smoking (RR = 1.25, 95% CI 0.55–2.82) 16 and lifetime
smoking (RR = 1.25, 95% CI 0.74–2.11), 14 but none of these results was
statistically significant.
4.4.4 Oppositional defiant disorder
Three studies assessed the association between oppositional defiant disorder and
smoking. 11,14,26 One found a significant twofold increase in the onset of daily
smoking (RR = 2.1, p