Cigarette smoking and schizophrenia
Patrick, Jon Alan
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Section 1 Introduction Cigarette smoking is anecdotally seen more often amongst schizophrenic than well subjects. Research has suggested a variety of explanations which are discussed; the role of genetics, psychosocial explanations and smoking as selfmedication. The financial, physical health and treatment options of and for nicotine dependence are also examined with reference to schizophrenia. Section 2 Systematic Review of Cigarette Smoking and Schizophrenia 50 studies were identified with a mean prevalence rate of smoking in schizophrenic populations of 66%. Male schizophrenics had a significantly higher (p=0.04) rate of smoking and smoked more heavily (p=0.01) than females. Different settings were also examined. Section 3 Meta-Analysis of Case-Control Studies examining the Prevalence of Smoking in Schizophrenia 11 studies were identified that could be examined in a meta-analysis comparing prevalence rates of smoking. Schizophrenic patients were found to be nearly 3 times more likely to smoke than controls. Section 4 Investigation into Patterns of Cigarette Smoking in Schizophrenia Using Data from the Edinburgh High-Risk Study (EHRS) At first interview there was a tendency (p=0.18) for high-risk group members with psychotic symptoms to have ever smoked compared to other high-risk and control subjects. Schizophrenic controls had a significantly higher prevalence of ever smoking compared to the high-risk and control groups (p=0.01). At the fourth interview there was a trend for high-risk subjects showed a nonsignificant difference in the rates of ever smoking compared with the controls (p=0.16). Those subjects who developed schizophrenia showed a clear trend (p=0.07) towards ever smoking Sections 5/6 Synthesis and Discussion of Results/Conclusion Explanations for the findings are presented. Although schizophrenia and cigarette smoking are inextricably linked, further studies are necessary if we are to more fully understand the nature of this association.