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Gurillo P, Jauhar S et al. Lancet Psychiatry 2015; 8: 718–725

Smoking cigarettes is associated with health risks. When considering dentistry, there is moderate evidence that smoking is linked to tooth loss (BMC Public Health 2011; 11: 221). Upstream approaches are central to enable changes in lifestyle. But in addition, healthcare workers including dental care professionals have a role in supporting those who wish to quit smoking. This meta-analysis examined the link between smoking and psychosis, particularly schizophrenia. Those with a psychotic illness may smoke to alleviate the distress of the condition, or because of the side-effects of the antipsychotic medication.

These investigators analysed 61 studies. Daily tobacco use was associated with: 1) increased risk of psychosis (for prospective studies, there was an overall relative risk of 2·18 – smokers were over twice the risk of developing psychosis compared with non-smokers), and 2) the age of onset of psychotic illness was earlier; although those with a psychosis did not smoke at an younger age than healthy controls. Few of the included studies reported on the consumption of other substances such as cannabis.