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Cigarette smoking in patients with schizophrenia

Division of Psychological Medicine, Institute of Psychiatry, De Crespigny Park, London SE5 8AF

EDITED BY LOUISE HOWARD

McCreadie & Kelly (2000) highlight the enormous financial cost of cigarette smoking to patients with schizophrenia and extrapolate from their data that those who smoke return 18-31% of their benefits to the Treasury, thus substantially contributing to the cost of their care. We directly measured the cost of smoking to a group of patients in Waterford and found that those who smoke spend an average of 29% of their income on cigarettes (McDonald & Sheppard, 1996). They thus contributed 24% of their income back to the Treasury in Ireland through this source alone, a proportion more akin to income tax for most people. This confirms the calculations of McCreadie & Kelly.

Aside from a curiously reduced risk of lung cancer (Gulbinat et al, 1992), patients with schizophrenia have increased mortality from heart and lung disease (Mortenson & Juel, 1993) and it is likely that cigarette smoking contributes largely to this. In addition to such adverse health effects, cigarette smoking clearly represents a huge financial burden on patients with schizophrenia. Money spent on cigarettes is not being spent on clothing, leisure pursuits and personal possessions, which could help to increase the quality of life of these patients. Smoking may be intimately associated with patho-physiological aspects of schizophrenia and further research should be done to clarify the relationship between nicotine consumption and the neurochemistry of schizophrenia. However, health care professionals should be aware of the extent of the financial disadvantage associated with this habit in order to help those patients who might wish to quit through encouragement and support and through prescription of nicotine supplementation where appropriate.

REFERENCES

Gulbinat, W., Dupont, A., Jablensky, A., et al (1992) Cancer incidence of schizophrenic patients. Results of record linkage studies in three countries. British Journal of Psychiatry, 161 (suppl. 18), 75-85.[Abstract/Free Full Text]

McCreadie, R. G. & Kelly, C. (2000) Patients with schizophrenia who smoke. Private disaster, public resource. British Journal of Psychiatry, 176, 109.[Free Full Text]

McDonald, C. & Sheppard, N. (1996) Smoking in chronic psychiatric illness: is it worth it? Psychiatric Bulletin, 20, 533-535.

Mortensen, P. B. & Juel, K. (1993) Mortality and causes of death in first admitted schizophrenic patients. British Journal of Psychiatry, 163, 183-189.[Abstract/Free Full Text]

This Article Full Text (PDF) Submit an eLetter Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via CrossRef Citing Articles via Google Scholar Google Scholar Articles by McDonald, C. Search for Related Content PubMed PubMed Citation Articles by McDonald, C.