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How is smoking related to schizophrenia? 

Tobacco smoking is very common among people with schizophrenia, who often show particularly heavy usage. This poses considerable health risks, may interfere with antipsychotic medications and may place a financial burden on the individual. Heavy cigarette use may contribute to the increased mortality and reduced life expectancy reported within the schizophrenia population.

What is the evidence for smoking?

Compared to the general population, moderate quality evidence finds higher rates of current smoking, heavy smoking, and lifetime smoking, and lower rates of smoking cessation in people with schizophrenia. People with first-episode psychosis, and those at ultra-high risk of psychosis also show highr rates of smoking, with rates of ~57% and ~33% respectively. There is also a medium-sized increased risk of psychotic disorders, and an earlier age of psychosis onset in smokers compared to non-smokers.
Compared to people with other mental disorders, moderate quality evidence finds people with schizophrenia show a small to medium-sized effect of higher rates of current smoking, and lower rates of smoking cessation.
Moderate quality evidence suggests the most commonly reported reasons for smoking were; relaxation/stress reduction, dysphoria relief, sociability, craving/addiction. The most commonly reported reasons for quitting were; self-control, health concerns and social influence. Barriers to smoking cessation were; cravings and addiction, perceived risk of negative affect, social pressures, stress and boredom reduction, and weight management. Knowledge about health risks of smoking, physician advice and social pressures to quit helped facilitate smoking cessation.

May 2019

Last updated at: 12:44 am, 8th May 2019
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Fact Sheet Technical Commentary

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Title Colour Legend:
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Orange - Topic summary is being compiled.
Red - Topic summary has no current systematic review available.