[4][5][6][7] Studies have also shown that in a male population, having a schizophrenia spectrum disorder makes it likely for people to use more tobacco.
[8] As a result, researchers believe it is important for mental health professionals to combat smoking among people with schizophrenia.
[5] The psychological tool hypothesis argues that smokers use nicotine to manipulate their mental state in response to various environmental conditions, such as reducing stress and managing negative emotions.
However, people with schizophrenia smoke at higher rates and for longer periods than other groups that experience both institutionalization and boredom.
[2][4][5] A 2003 study of over 50,000 Swedish conscripts found that there was a small but significant protective effect of smoking cigarettes on the risk of developing schizophrenia later in life.
However, 28% cite psychiatric issues, including response to auditory hallucinations and reducing the side effects of medication.
The major themes found in studies of personal perspectives are habit and routine, socialization, relaxation, and addiction to nicotine.
Another theory is based on animal models showing that chronic nicotine use eventually results in a reduction in dopamine, thus alleviating positive symptoms.
Studies show increased numbers of exposed nicotinic receptors, which could explain the pathology of both smoking and schizophrenia.
Nicotine may help improve auditory gating, the ability to screen out intrusive environmental sounds.
This may help improve attention spans and reduce auditory hallucinations, allowing people with schizophrenia to perceive the environment more effectively and engage in smoother motor functions.
Ten-year coronary heart disease risk is significantly elevated in people with schizophrenia, as well as diabetes and hypertension.
[4][5][7] Tobacco smoking increases the metabolism of some antipsychotics, by strongly activitating CYP1A2, the enzyme that breaks them down, and a significant difference is found in these levels between smokers and non-smokers.
One major impact is financial, as people with schizophrenia have been found to spend a disproportionate amount of their income on cigarettes.
The industry also provided cigarettes to hospital wards and supported efforts to block hospital-based smoking bans.
[16] There is evidence that multimodal smoking cessation programs using both pharmacologic therapy (with varenicline or bupropion) and nicotine replacement can be effective without worsening symptoms of schizophrenia.
[18] However, research showing that eliminating even one risk factor for disease can significantly improve long-term health outcomes has resulted in the dominant view among clinicians opposing smoking.
Clinicians should also be aware of the consequences that can result from a lack of cigarettes, such as aggression, prostitution, trafficking, and general disruption.