Smoking in schizophrenia — all is not biological

• Published in: Schizophrenia research Vol. 56; no. 1; pp. 67 - 74
• Main Authors: Srinivasan, T.N., Thara, R.
• Format: Journal Article
• Language: English
• Published: Amsterdam Elsevier B.V 01.07.2002; Elsevier Science
• Subjects: Addictive behaviors; Adult; Adult and adolescent clinical studies; Biological and medical sciences; Bipolar Disorder - epidemiology; Bipolar Disorder - psychology; Comorbidity; Cross-Cultural Comparison; Cross-Sectional Studies; Depressive Disorder, Major - epidemiology; Depressive Disorder, Major - psychology; Developing Countries; Humans; India; India - epidemiology; Male; Medical sciences; Mental Disorders - epidemiology; Mental Disorders - psychology; Middle Aged; Psychology. Psychoanalysis. Psychiatry; Psychopathology. Psychiatry; Psychoses; Risk Factors; Schizophrenia; Schizophrenia - epidemiology; Schizophrenia - physiopathology; Schizophrenic Psychology; Smoking; Smoking - adverse effects; Smoking - epidemiology; Smoking - physiopathology; Social and economic restriction; Socioeconomic Factors; Tobacco smoking; Tropical medicine; Urban Population - statistics & numerical data; Asia; India; Schizophrenia; Social and economic restriction; Smoking; India; Consumption; Social environment; Human; Urban environment; Prevalence; Education level; Mental health; Male; Economic status; Professional status; Psychosis; Alkaloid; Tobacco; Marital status; Sociodemographic factor; Cultural environment; Family environment; Diagnosis; Age; Comparative study; Public health; Nicotine
• ISSN: 0920-9964; 1573-2509
• DOI: 10.1016/S0920-9964(01)00187-6

High rate of tobacco smoking reported in schizophrenia has been related to the effect of nicotine on the neurobiology of schizophrenia. Nicotine is said to alleviate psychotic symptoms in some patients. The relationship between smoking and psychiatric status may not be simply a biological one as several sociocultural and economic factors could influence smoking behaviour. In this study in India on 286 urban male outpatients with schizophrenia, only 38% were found to be current smokers. This was significantly more than in other psychiatric patients studied (major affective disorders and non-psychotic disorders) but not medically ill controls and not higher than the rates for the general male population in India. Smokeless use of tobacco was infrequent in the study population. More than half of the patients did not experience any positive effects due to smoking. Lack of economic independence and restrictions imposed by the family appeared to be crucial factors that controlled the prevalence of smoking among schizophrenia patients. As smoking is a leading cause of preventable morbidity and mortality, there is a serious need to review the neurobiological issue of smoking in schizophrenia considering the influence culture and social practices could have upon the behaviour.