As a former music therapist with years of working with adults with mental illness, I remember distinctly the smoking ritual which took up a tremendous portion of each person's day. These adults had a dual diagnosis of schizophrenia and substance abuse, a twinship that seemed to be more common than not. The main substance of choice for all of them, without exception, was nicotine.
It's been found that many people suffering from schizophrenia experience a reduction in the negative symptoms of the disease (hallucinations, delusions) when they are smoking and an increase in these symptoms when they cease smoking. It is inferred, therefore, among some practitioners, that smoking is itself a form of self-medicating which people with schizophrenia naturally gravitate toward.
The problem, of course, is that smoking is just as much of a health hazard for those suffering with mental illness as it is for anyone else in the general population. The increase of asthma, emphysema, lung and mouth cancer, as well as heart disease compounds the mental, emotional and physical struggles that people with schizophrenia are already facing. The medical costs of smoking are tremendous, as well, not to mention the cost of cigarettes themselves.
Many people with mental illness work very hard to budget their money and the cost of smoking takes their health as well as their income from them. With many brands costing upwards of $7.00 per pack, and many people with schizophrenia smoking more than one pack each day, it would most certainly be in their best interest to quit the habit.
The medical community is only now realizing there may be genetic links between smoking and schizophrenia. The receptors that allow someone to enjoy and become addicted to nicotine may be related to those that influence the chemistry of developing schizophrenia. While research is still being conducted, it is clear to see that this population is in fact voracious when it comes to smoking, sometimes smoking, or trying to smoke (if there are imposed limits) anywhere from one to three or even four packs per day of cigarettes.
People with schizophrenia will also, if given the right mix of frustration and sense of powerlessness, sometimes resort to unhealthy ways of dealing with their addiction. They may rummage through trash to find old cigarette ends or steal cigarettes from someone else; both potentially putting them at risk for further injury or harm.
As an advocate for those with mental illness, and as anyone who loves someone with this condition, supporting their smoking is not helpful, but enabling. It is obvious that they enjoy it and seem to develop a true dependence on nicotine. But slowly weaning off of this powerful substance will only benefit them in the long run.
Sources:
A Review of the Effects of Nicotine on Schizophrenia and Antipsychotic Medications
Edward R. Lyon, M.S., Ed.D.
http://psychservices.psychiatryonline.org/cgi/content/full/50/10/1346
Schizophrenia and Nicotine
http://www.psychologyinfo.com/schizophrenia/nicotine.html
Nicotine Dependence in Schizophrenia: Clinical Phenomena and Laboratory Findings
Gregory W. Dalack, M.D., Daniel J. Healy, M.D., and James H. Meador-Woodruff, M.D.
http://ajp.psychiatryonline.org/cgi/content/full/155/11/1490
Aimee Boyle is a former music therapist and currently a mom and special education teacher. She is a regular contributor to EmpowHER.
Reviewed September 1, 2011
by Michele Blacksberg R.N.
Edited by Jody Smith