Schizophrenia and Smoking: What Factors Raise the Prevalence?

It is well known that smoking is highly prevalent among patients with schizophrenia, likely serving as a coping mechanism for their symptoms and medication side effects, according to the self-medication hypothesis.

However, new findings presented at the American Psychiatric Association’s 2018 Annual Meeting in New York, NY, have indicated that schizophrenia patients in an inpatient setting are significantly more likely to smoke cigarettes compared with those in an outpatient clinic.

YOU MAY ALSO LIKE
1 in 10 Suicide Deaths Linked With Schizophrenia
Early Intervention Linked With Better Schizophrenia Outcomes

“Since the odds of being a smoker was found to be significantly less in the outpatient clinic compared [with] the inpatient setting, the result suggests that there was an association between the severity of [schizophrenia] and smoking status,” the researchers wrote.

For their study, Mei Wai Lam, MD, MPH, and colleagues evaluated 114 patients with schizophrenia who were recruited from inpatient and outpatient clinics, as well as partial hospitalization programs. Of these patients, 63.16% were smokers.

Each patient was assessed via several questionnaires and scales, including the Short Assessment of Health Literacy, Cohen’s Social Network Index, Fagerstrom Test for Nicotine Dependence (FTND), and PANNS-6—the short version of Positive and Negative Symptoms in Schizophrenia.

Results of the study revealed that individuals in an outpatient clinic setting had a 79% lower likelihood of smoking compared with those in an inpatient setting.

Conversely, patients who engaged in concurrent drug and alcohol use were much more likely to smoke cigarettes. The odds of cigarette smoking were 3.4 times higher in patients who used alcohol and 3.9 in those who used drugs.

Body mass index and pack years were found to be positively and significantly associated with FTND score among patients who smoked cigarettes.

However, social network and health literacy did not appear to affect patients’ odds of smoking. No significant differences were observed for PANNS-6 scores between smokers and non-smokers.

“The significant association between cigarette smoking, alcohol use, and drug use suggest that the factors associated with substance abuse must be taken into consideration together in this patient population,” the researchers concluded. “Further interventions intended to address concurrent nicotine, alcohol, and drug use among patients with [schizophrenia] are warranted.”

—Christina Vogt

Reference:

Lam MW, Dumenigo A, Goubran B, Sanchez-Gonzalez M. Study on psychosocial factors and cigarette smoking in schizophrenia. Paper presented at: American Psychiatric Association Annual Meeting; May 5-9, 2018; New York, NY.