Cigarette Smoking, Alcohol and Cannabis Use in Patients With Pervasive Developmental Disorders

Background and objectives: This study aimed to examine the rates of cigarette smoking, alcohol and cannabis use among patients with pervasive developmental disorder (PDD), in order to determine whether they are relatively protected from developing substance-related addictive behaviors. Methods: This case–control study included 85 patients diagnosed with PDD and 85 age- and gender-matched nonpsychotic psychiatric patients without PDD. Data were collected from the patients' electronic medical records and included demographic and psychiatric parameters, as well as data on smoking, alcohol, and cannabis use. Results: A lower rate of cigarette smoking was found among patients diagnosed with PDD in comparison to those without PDD [20.0% vs. 52.9% respectively, p <.001). The likelihood of smoking in PDD was found to be 3.57-fold lower than in psychiatric controls [OR = 3.57 (95% CI 1.69-7.14), p =.001]. A multivariate analysis showed that after adjusting for age, comorbid diagnoses and use of an antipsychotic medications, this effect was even more robust with the likelihood of smoking in PDD decreasing even more substantially compared to controls [OR = 8.33 (95% CI 2.86-25), p <.001]. A similar finding was noted when comparing the prevalence of alcohol and cannabis use between the two groups [OR 6.67 (95%CI 1.30-33.33), p =.02 and 5.55 (95%CI 1.30-25), p =.01, respectively]. Conclusions: PDD is associated with 5-8-fold lower adjusted risk of smoking, alcohol and cannabis use compared to other non-psychotic psychiatric patients. Further research should elucidate the neurobiological and psychosocial mechanisms underlying the apparent addiction protective properties of PDD.