Aims: The cross-sectional association between tobacco use and psychotic features has been well established. If psychotic features precede tobacco use, then tobacco may be used to self-medicate psychotic symptoms. The aim was to assess if psychotic features in adolescents constitute a risk factor for later tobacco use.
Design: A random target sample of 2,600 children aged 4-16 years from the Dutch general population was followed up across a 14-year interval. At different ages (childhood, adolescence, young adulthood), information about visual and auditory hallucinations was obtained using standardized questionnaires for parents and subjects themselves. At outcome (ages 18-30), tobacco use was assessed.
Findings: Auditory hallucinations, but not visual hallucinations, in early and late adolescence, assessed via parents and adolescents themselves, predicted tobacco use in adulthood.
Conclusions: The present study confirmed that auditory psychotic features in adolescence are associated with tobacco use in adulthood. Tobacco may be used to self-medicate auditory, but not visual, hallucinations.