Abstract
Many studies across different countries demonstrate consistently an association between schizophrenia and current smoking. This association is relatively independent of sociocultural factors. Schizophrenia is found to be associated with high nicotine dependence when schizophrenic smokers are compared with smokers from the general population, but not when they are compared with smokers with other severe mental illnesses. The increased prevalence of ever smoking in schizophrenic patients and the higher rates of smoking initiation before schizophrenia starts suggest that people who are going to develop schizophrenia have some risk factors that make them more vulnerable to start smoking. The reinforcing nicotine properties may be associated with dopamine release, which may allow to make links with the dopamine hypothesis of schizophrenia. The polycyclic aromatic hydrocarbons in tobacco smoke are metabolic inducers of clozapine, olanzapine and typical antipsychotics. Limited and small studies suggest that typical antipsychotics may increase smoking and make it difficult to quit smoking, while clozapine treatment is associated with small smoking decreases. The self-medication hypothesis in schizophrenia proposes that smoking would improve cognition, decrease depressive, anxious and positive symptoms, decrease antipsychotic side effects, and favor psychosocial interaction; but clinical studies do not appear to demonstrate these allegedly beneficial effects. Clinicians trying to help patients with schizophrenia quit smoking need to be flexible, so that if abstinence is not possible smoking reduction can be an appropriate goal.
Translated title of the contribution | Smoking and schizophrenia |
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Original language | Spanish |
Pages (from-to) | 177-190 |
Number of pages | 14 |
Journal | Adicciones |
Volume | 16 |
Issue number | SUPPL. 2 |
State | Published - 2004 |
Keywords
- Nicotine
- Schizophrenia
- Smoking
- Tobacco
ASJC Scopus subject areas
- Medicine (miscellaneous)
- Psychiatry and Mental health