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. 2023 Feb;17(2):192-201.
doi: 10.1111/eip.13320. Epub 2022 Jun 24.

Prevalance and course of tobacco use among individuals receiving coordinated specialty care for first-episode psychosis

R Tyler Rogers  1 , Leslie Marino  1   2 , Jennifer Scodes  1 , Melanie Wall  1   2 , Ilana Nossel  1   2 , Lisa Dixon  1   2
Affiliations

Prevalance and course of tobacco use among individuals receiving coordinated specialty care for first-episode psychosis

R Tyler Rogers et al. Early Interv Psychiatry. 2023 Feb.

Abstract

Aim: Tobacco use is decreasing among the general population, but persistent use among individuals in treatment for first-episode psychosis (FEP) remains a problem. This study aimed to measure the prevalence and course of tobacco use and explore the associations between tobacco use and clinical outcomes in a FEP sample located in New York State (NYS).

Methods: Participants (N = 870) were from the OnTrackNY system of coordinated specialty care clinics in NYS. Participant data were collected at admission to the program and at every 3 months of follow-up using standardized forms based on reports from clients, client families and chart review. Course of tobacco use was categorized into four groups: no-use, cessation, persistent and initiation over 1 year of follow-up.

Results: The prevalence of tobacco use was 12.8% at baseline and 19.9% at 1-year follow-up. Only 3.8% of tobacco users stopped by 1 year follow-up, and 4.9% initiated use. Urbanicity of clinic location (p < .001); age at admission (p = .044); gender (p = .015); ethnoracial group (p = .007); baseline education/employment status (p = .004); and baseline use of any non-tobacco substances (p < .001), including alcohol (p < .001) and cannabis (p < .001), were associated with tobacco course. Findings suggest an association between tobacco use and reduced improvement in symptoms.

Conclusion: Despite a lower prevalence of tobacco use among OnTrack participants than in other comparable samples, tobacco cessation was minimal and more individuals initiated tobacco use than ceased over the course of follow-up. Efforts to implement tobacco cessation interventions in coordinated specialty care are warranted, since tobacco use is associated with poor health outcomes.

Keywords: coordinated specialty care; first-episode psychosis; prevalence; smoking; tobacco.

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Conflict of interest statement

Conflicts of Interest

The authors have no conflicts of interest to declare.

Figures

Figure 1
Figure 1
Model estimated means and 1-standard error bars of MIRECC GAF symptom scores by course of tobacco use among one-year completers
Figure 2
Figure 2
Model estimated prevalence and 1-standard error bars of psychiatric hospitalizations by course of tobacco use among one-year completers
Figure 3
Figure 3
Model estimated prevalence and 1-standard error bars of medication adherence by course of tobacco use among one-year completers
Figure 4
Figure 4
Responses to the OnTrackNY Nutrition, Physical Activity, and Substance Use Survey (2017; n=38)
See this image and copyright information in PMC

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