Schizophrenia and Smoking

In a letter to the editor of Schizophrenia Research, co-written by UW-CTRI researcher Megan Piper, researchers concluded that, like smokers in the general population, smokers with Schizophrenia report multidimensional drives for smoking, although they may be more sensitive to the positive effects of smoking and have greater emotional attachment to cigarettes. Further, they found that individuals with schizophrenia or schizoaffective disorder may smoke for different reasons than those without serious mental illness.

Compared to smokers in the general population, smokers with schizophrenia have increased smoking rates, increased nicotine dependence and reduced success in smoking cessation. The primary objective of this study was to examine differences between motives to smoke among smokers with and without schizophrenia as measured by the WISDM-68 scale, created by UW-CTRI researchers. As part of a secondary data analysis of three existing datasets, researchers sought to examine motives for smoking in eighty individuals with schizophrenia or schizoaffective disorder as compared to 463 control smokers without any mental illness. All participants with schizophrenia or schizoaffective disorder were already enrolled in mental health treatment and stable on antipsychotic medications.

“Compared to controls, smokers with schizophrenia may be more likely to smoke for a stimulation effect,” said Megan. This finding is consistent with studies of substance abuse in schizophrenia which often show higher use of stimulants (amphetamines, cocaine, caffeine, and nicotine) compared to other psychiatric patients or to those without any mental illness.

Additionally, individuals with schizophrenia may be more likely to smoke in order to ameliorate a variety of negative internal or aversive states, including negative affect, and nicotine withdrawal as compared to control smokers (15%), to pass the time (12%) and for use as a crutch (8%). Some national research has shown that patients with schizophrenia report that smoking decreases hallucinations or voices, although smoking doesn’t eliminate them.

“Because individuals with schizophrenia have a higher incidence of smoking, it is imperative to understand motives for smoking across multiple dimensions,” researchers wrote. “Such data could be of great significance for future research and may help guide future tobacco-dependence cessation treatments in this group.” This work was supported in part by NIDA grants.

Galazyn M, Steinberg ML, Gandhi KK, Piper M, Williams JM. Reasons for Smoking Among Individuals with Schizophrenia (letter to editor). Schizophrenia Research. Sept. 2010;122(1-3):268-9.