Smoking habits, current symptoms, and premorbid characteristics of schizophrenic patients in Nithsdale, Scotland

Objective: Previous studies of smoking habits of schizophrenic patients hav e found rates as high as 88%. The authors report the smoking habits of all known schizophrenic patients within a discrete geographical area and compar e them with the smoking habits of a general population sample, Method: All known schizophrenic patients in Nithsdale in South-West Scotland (N=168) we re invited to complete it questionnaire on smoking habits. Also assessed we re mental state, drug-related side effects, and premorbid childhood persona lity and social adjustment. Results: One hundred thirty-five of the 168 pat ients returned the questionnaires. The rate of smoking among the patients w as 58% (N=78), compared with 28% in the general population. Sixty-eight per cent of the patients who smoked (N=53) had 25 or more cigarettes per day. T he mean age at starting smoking was 17 years in both patients and normal su bjects. Ninety percent of the patients who smoked (N=70) started smoking be fore the onset of schizophrenia. Patients who smoked were younger than nons mokers, and more of them were male. They had had more hospitalizations, and more were in contact with psychiatric services. More were-receiving intram uscular antipsychotic medication. Smokers had poorer childhood social;adjus tment. Among the female patients, there was a positive correlation between age at starting smoking and age at onset of schizophrenia. Conclusions: The rate of smoking and level of nicotine addiction are greater in schizophren ic patients than in the general population. Smoking may be a marker for the neurodevelopmental form of the illness and may be another environmental ri sk factor for schizophrenia in vulnerable individuals.