A twin study on the association between psychotic experiences and tobacco use during adolescence

Barkhuizen, W. and Taylor, M.J. and Freeman, D. and Ronald, Angelica (2018) A twin study on the association between psychotic experiences and tobacco use during adolescence. Journal of the American Academy of Child and Adolescent Psychiatry 58 (2), 267-276.e8. ISSN 0890-8567.

Abstract

Objective: Psychotic experiences (PE) are dimensional phenomena in the general population that resemble psychotic symptoms, such as paranoia and hallucinations. This is the first twin study to explore the degree to which tobacco use and PE share genetic or environme ntal influences. Previous studies on the association between adolescent tobacco use and PE have not considered PE dimensionally, included negative symptoms, or accounted for confounding by sleep disturbance and stressful life events . Method: An unselecte d adolescent twin sample (N=3787 pairs; M age=16.16 years) reported on PE (paranoia, hallucinations, cognitive disorganization, grandiosity and anhedonia) and regularity of tobacco use. Parents rated the twins’ negative symptoms. Regression analyses were c onducted while adjusted for sociodemographic characteristics, prenatal maternal smoking, cannabis use, sleep disturbance, and stressful life events. Bivariate twin modelling was employed to estimate the degree of genetic and common and unique environmental influences shared between tobacco use and PE. Results: Regular smokers were significantly more likely to experience paranoia, hallucinations, cognitive disorganization and negative symptoms ( E =.17 - .34), but not grandiosity or anhedonia, than non - smokers, after adjustment for confounders. Paranoia, hallucinations and cognitive disorganization correlated ≥ .15 with tobacco use ( r = .15 - .21, all p<.001). Significant genetic correlations (r A =.37 - .45) were found. Genetic influences accounted for most of the ass ociation between tobacco use and paranoia (84%) and cognitive disorganization (81%). Familial influences accounted for 80% of the association between tobacco use and hallucinations. Conclusion: Tobacco use and PE during adolescence were associated after ad justment for confounders. They appear to co - occur largely due to shared genetic influences. Lay summary: Individual psychotic experiences, such as paranoid thoughts and having hallucinations, were assessed in this study as dimensional phenomena in the comm unity in mid - adolescence, alongside tobacco use. The classic twin design including identical and fraternal twins was employed, with a sample of approximately 3700 twin pairs in mid - adolescence. Regular tobacco use was found to be associated with psychotic experiences during adolescence even after taking account possible confounds such as social background, cannabis use, maternal smoking during pregnancy, sleeping habits and stressful life events. S ome the same genetic influences were found to underlie adolescent smoking and individual psychotic experiences, specifically paranoia, hallucinations and cognitive disorganization.

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