Perception of Smoking Risks and Motivation to Quit Among Nontreatment-Seeking Smokers With and Without Schizophrenia

Kelly, Deanna L.; Raley, Heather; Lo, Suzanne; Wright, Katherine S.; Fang, Liu; McMahon, Robert P.; Moolchan, Eric T.; Feldman, Stephanie; Richardson, Charles M.; Wehring, Heidi J.; Heishman, Stephen J.

doi:10.1093/schbul/sbq124

Cited by 45 publications

(53 citation statements)

References 40 publications

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“…Other potential reasons include self-medication of negative/cognitive symptoms and neurophysiological abnormalities (Winterer 2010), depressive symptoms (Lising-Enruquez and George 2009), a means of activity or staving off boredom (Roick et al 2007), or to decrease the extrapyramidal side effects of antipsychotics (Madden et al 1997). Previous work from our group has found that people with schizophrenia report more frequently than controls that smoking improves the ease of social interaction and state enhancement (Kelly et al 2010). However, a recent study (Levander et al 2007) found no difference between nicotine users and non-users with schizophrenia spectrum disorders on symptoms, side effect, cognition, and outcome.…”

Section: Introductionmentioning

confidence: 89%

“…Studies of cessation interventions in patients with schizophrenia have found varying rates of success, although positive results have been reported in the literature (Baker et al 2006; George et al 2008). Motivation for quitting may be lower in schizophrenia, as Kelly et al (2010) found that motivation for quitting smoking in persons with schizophrenia is significantly lower than in controls. Baker et al (2007) reported that, compared to general population samples, persons with psychotic disorders were more likely to indicate that stress reduction, stimulation, and addiction were reasons for smoking.…”

Section: Introductionmentioning

confidence: 99%

“…Potential targets and challenges therefore exist for timing and type of smoking interventions in this population. Of additional concern, Kelly et al (2010) also found that, compared to normal controls, people with schizophrenia demonstrated a significantly lower appreciation of the health risks that are a consequence of cigarette smoking, and rated health risks as less of a motivator for smoking cessation.…”

Section: Introductionmentioning

confidence: 99%

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Clinical characteristics of heavy and non-heavy smokers with schizophrenia

Wehring¹,

Liu²,

McMahon³

et al. 2012

Schizophrenia Research

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Up to 50–90% of persons with schizophrenia smoke cigarettes. Limited data and theories suggest persons with schizophrenia may smoke for different reasons than persons without schizophrenia, making smoking cessation interventions particularly challenging in this population. Although health consequences of smoking are widely known, less information is available regarding characteristics of different amounts of smoking exposure in this population. This study was performed to investigate differences between heavy (≥1 pack per day) and non-heavy (<1 pack per day) smoking in patients with schizophrenia. Data from 745 patients, mean age 41.3 +/−12.6 years, were drawn from a population of smokers admitted to State of Maryland inpatient mental health facilities (1994–2000). Records were reviewed to obtain demographic information, diagnosis, medication, smoking and substance use. 43% of patients were characterized as heavy smokers. Heavy and non-heavy groups did not differ in age, GAF, weight, or BMI. No differences were found in race, gender or antipsychotic treatments. However, patients smoking ≥1 packs per day were more likely to use other substances such as alcohol (χ2=6.67, df=1, p=0.01), cocaine (χ2=6.66, df=1, p=0.01), and other substances (χ2=9.95, df=1, p=0.003) compared to non-heavy smokers. No differences in cannabis or heroin use were found by smoking category. Controlling for age, race, sex and BMI, heavy smokers had higher total cholesterol (190.7(51.6) mg/dl) compared to non-heavy smokers (178.2 (43.0) mg/dl, p=0.03), but no differences were found in glucose or blood pressure. Heavy smoking may be a particular health risk in schizophrenia and significant efforts for smoking cessation or reduction are needed.

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Section: Introductionmentioning

confidence: 89%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Clinical characteristics of heavy and non-heavy smokers with schizophrenia

Wehring¹,

Liu²,

McMahon³

et al. 2012

Schizophrenia Research

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“…However, they are more motivated to receive support once they have decided to quit [82]. Patients with schizophrenia are less motivated to quit compared to general smokers [87,88]. Most of them think that smoking helps to alleviate negative symptoms and cognitive deficits, enhances cognitive performance, and provides psychomotor stimulation [17,89].…”

Section: Awareness and Motivation Patients With Chd Whomentioning

confidence: 99%

Smoking Cessation in Long-Term Conditions: Is There “An Opportunity in Every Difficulty”?

Siddiqi

Dogar

Siddiqi

2013

International Journal of Population Research

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Introduction. Smoking plays a causal role in several long-term conditions and worsens their outcomes. Focusing on six such conditions, we present a narrative review of seminal studies on the prevalence and impact of continued tobacco use on these conditions; the effectiveness of cessation interventions; the extent to which patients receive these interventions, and barriers to providing and taking up these interventions. Methods. A conceptual framework was used to identify questions for a series of focused literature reviews. Findings were synthesized and the literature was examined to identify themes common across these conditions. Results. Smoking prevalence is either similar or higher in patients with established long-term conditions compared to the general population. Continued smoking accelerates disease progression, worsens outcomes, and risks poor treatment compliance or further complications. There is strong evidence for the effectiveness of cessation interventions in achieving smoking abstinence. Despite this, only a small proportion of patients receive such interventions. Important barriers to uptake include concerns about weight management and drug safety, higher nicotine dependency and codependency, comorbidity, and misperceptions about the benefits of cessation. Conclusion. The benefits of offering smoking cessation in patients with long-term conditions are far too great for it to remain of a low priority.

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“…Participants completed assessments gathering demographics, smoking history/behavior, and nicotine dependence. This study is a secondary analysis of a larger study examining smoking craving between smokers with schizophrenia and healthy smokers (Kelly et al, 2012; Lo et al, 2011; Mackowick et al, 2012). This analysis will report the smoking characteristics of smokers with schizophrenia by antipsychotic group.…”

Section: Methodsmentioning

confidence: 99%

Antipsychotic Treatment and Tobacco Craving in People With Schizophrenia

Wehring

Heishman

McMahon

et al. 2017

Journal of Dual Diagnosis

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Objective Nicotine dependence is high in schizophrenia, and craving is known to impact relapse during quit attempts. Methods We compared tobacco craving in smokers with schizophrenia treated with different antipsychotics. Results Mean craving scores were lowest in participants treated with first generation antipsychotics, although these differences were not statistically significant. Craving with clozapine was not lower than with other antipsychotics. Conclusions Further research is needed to determine if differences in craving exist between antipsychotic classes.

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Perception of Smoking Risks and Motivation to Quit Among Nontreatment-Seeking Smokers With and Without Schizophrenia

Abstract: This study underscores the degree to which people with schizophrenia perceive the state-enhancing effects of smoking and their lower appreciation for health risks of smoking compared with normal controls.

Cited by 45 publications

References 40 publications

Clinical characteristics of heavy and non-heavy smokers with schizophrenia

Clinical characteristics of heavy and non-heavy smokers with schizophrenia

Smoking Cessation in Long-Term Conditions: Is There “An Opportunity in Every Difficulty”?

Antipsychotic Treatment and Tobacco Craving in People With Schizophrenia

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