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Odds ratios (<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content>s) and their 95% confidence intervals (<jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>s) compared current smoking, heavy smoking among current smokers, smoking cessation in ever smokers, and ever smoking in bipolar disorder versus control groups.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The combined<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content>was 3.5 (<jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>: 3.39\u20133.54) in 51 current smoking studies of bipolar disorder versus the general population from 16 countries. More limited data provided an<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content>\u00a0=\u00a00.34 (<jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>: 0.31\u20130.37) for smoking cessation and an<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content>\u00a0=\u00a03.6 (<jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>: 3.30\u20133.80) for ever smoking. The combined<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content>was 0.76 (<jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>: 0.74\u20130.79) for current smoking in bipolar disorder versus schizophrenia in 20 studies from ten countries. Ever smoking may be lower in bipolar disorder than in schizophrenia (<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content>\u00a0=\u00a00.83,<jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>: 0.75\u20130.91). The<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content>was 2.05 (<jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>: 2.00\u20132.10) for current smoking in bipolar disorder versus major depression in 18 studies from seven countries. Ever smoking may be higher (<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content>\u00a0=\u00a01.5,<jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>: 1.40\u20131.70) and smoking cessation lower (<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content>\u00a0=\u00a00.51,<jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>: 0.45\u20130.59) in bipolar disorder than in major depression.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Increased current smoking in bipolar disorder versus the general population reflected increased ever smoking (initiation) and decreased smoking cessation. Smoking behavior frequencies in bipolar disorder may be between those in depressive disorder and schizophrenia, with schizophrenia showing the highest severity level.<\/jats:p><\/jats:sec>","DOI":"10.1111\/bdi.12319","type":"journal-article","created":{"date-parts":[[2015,8,4]],"date-time":"2015-08-04T06:13:45Z","timestamp":1438668825000},"page":"575-597","source":"Crossref","is-referenced-by-count":112,"title":["A combined analysis of worldwide studies demonstrates an association between bipolar disorder and tobacco smoking behaviors in adults"],"prefix":"10.1111","volume":"17","author":[{"given":"James G","family":"Jackson","sequence":"first","affiliation":[{"name":"College of Medicine University of Kentucky Lexington KY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francisco J","family":"Diaz","sequence":"additional","affiliation":[{"name":"Department of Biostatistics The University of Kansas Medical Center Kansas City KS 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