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. This topic considers the evidence for the rates of smoking among people with schizophrenia. Please also see the topic on the effects of smoking on the course and outcomes of the disorder.

What is the evidence for smoking?

Moderate quality evidence suggests around 65% of people with schizophrenia have a tobacco use disorder or nicotine dependence, with rates higher in males than females.

Compared with 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, with the prevalence of smoking cessation in people with schizophrenia is around 14%.

People with first-episode psychosis, and those at ultra high-risk of psychosis also show higher rates of smoking than the general population, 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 with people with other mental disorders, moderate quality evidence suggests people with schizophrenia show a small to medium-sized effect of higher rates of current smoking, and lower rates of smoking cessation.

March 2022

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Last updated at: 2:46 pm, 28th March 2022
To view documentation related to this topic download the files below
Fact Sheet Technical Commentary
Tags:  Smoking

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