Tobacco smoking is common in schizophrenia. Some characteristics are usually associated to tobacco smoking in schizophrenia, such as younger age, earlier onset of the disease, number of hospitalizations or higher treatment doses. However, little is known about positive symptoms or aggressiveness, as well as trauma history.

to study the relationship between smoking status and clinical characteristics in patients with schizophrenia.

A total of 474 patients with were consecutively included in the network of FondaMental Expert Center (FACE) for schizophrenia and assessed with the structural clinical interview for DSM-IV axis 1 disorders (SCID), validated scales for psychotic symptomatology and childhood trauma questionnaire. Tobacco abuse or dependence was defined according to the SCID. Ongoing antipsychotic treatment was recorded. Aggressiveness was measured with Buss-Perry Aggression Questionnaire (BPAQ).

A sample of 474 patients with schizophrenia was included in this study (non-smokers, n = 215; non-smokers, n = 259). Mean age at tobacco onset was 17.19 years old (SD = 3.93). In multivariate analysis, smoking was associated with SGA use (P = 0.028), with higher scores of physical aggressiveness (P = 0.042), with current alcohol-dependence (P = 0.002). However, no association was observed with sex, age of onset, trauma history, global functioning, observance or psychotic symptomatology.

Tobacco smoking was associated with physical aggressiveness, but not with earlier onset of the disease nor traumas or psychotic symptomatology. Besides, the results of the present study are in favor of a superior efficacy of second-generation antipsychotics in the treatment of comorbid tobacco use. These results need further investigation in longitudinal studies.

The authors have not supplied their declaration of competing interest.