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Why Do So Many Schizophrenics Smoke?


Linda Wasmer Andrews

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Stubbing Out Smoking

Studies show that doctors don't warn people with schizophrenia about the hazards of smoking the way they do other patients. Yet people with schizophrenia have a 1.5 time greater risk of dying prematurely than those without the illness. Their life expectancy is reduced by 20 to 30 years compared with the general population. Smoking plays a big part in that risk. It takes a harsh toll on the body. And it's hard on the wallet, too. If you're on a tight budget, affording cigarettes may mean skimping on food or medical care.

The two main tools to help with quitting smoking are counseling and medications. Studies show that both approaches can be helpful for people with schizophrenia.

When smokers first quit, withdrawal symptoms may occur as the body gets used to life without nicotine. These symptoms—such as dizziness, anxiety, irritability, trouble sleeping, and headaches—are temporary but unpleasant. And they may be worse than average for people with schizophrenia. Medications can help people get through this tough phase. Options include nicotine products, such as patches and gum, and non-nicotine medications, such as bupropion. You and your doctor must keep an eye on your response to antipsychotic drugs during this time. Smoking often makes such drugs less effective. So as a nice side benefit, you might be able to reduce your dose of antipsychotic medication once you stop smoking. However, changing your medications should only be tried together with your prescribing doctor.

Giving up smoking isn't easy. But it is possible. If you plan to quit, ask your doctor about the best approach for you.

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Medical Reviewers: William C. Lloyd III, MD, FACS Last Review Date: Apr 7, 2017

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Medical References

  1. Smoking and Mental Health. National Alliance on Mental Illness.
  2. Smoking and Schizophrenia, Society for Neuroscience. November 2012$0.26964.20327$88...
  3. Guide to Quitting Smoking. American Cancer Society. November 23, 2009.
  4. Comorbidity: Addiction and Other Mental Illnesses. National Institute on Drug Abuse. May 27, 2009.
  5. Impacts of Drugs on Neurotransmission. National Institute on Drug Abuse. October 2007.
  6. What About Substance Abuse? National Institute of Mental Health. September 8, 2009
  7. What Causes Schizophrenia. National Institute of Mental Health. September 8, 2009.
  8. Expert Panel Addresses High Rates of Smoking in People With Psychiatric Disorders. National Institute of Mental Health. May 6, 2009.

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