Initiation of daily smoking and nicotine dependence in schizophrenia and mood disorders

Leon, José de; Díaz, Francisco Javier Rodríguez; Rogers, Thea; Browne, Debra; Dinsmore, Lori

doi:10.1016/s0920-9964(01)00217-1

Cited by 148 publications

(101 citation statements)

References 9 publications

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“…De Leon et al 22 found an average FTND of 6.2 for inpatients (schizophrenia, schizoaffective, bipolar disorder, and major depression), while a Spanish and an American mixed inpatient-outpatient study found FTND scores of 6.6 and 6.3, respectively. 25 The higher severity of nicotine dependence reported in the aforementioned studies may reflect higher prevalence of smoking in the general population of other countries (European), samples with potentially greater severity of psychiatric illness reflecting differences in admitting practices between countries, and (or) specific, more homogenous diagnostic groups (for example, only psychotic patients). The current study attempted to include a sample typical of patients and diagnoses admitted to acute care Canadian hospitals to allow for generalization of findings to inpatients treated by Canadian psychiatrists.…”

Section: Discussionmentioning

confidence: 95%

“…[45][46][47][48] The wide use of FTND offers comparisons between populations, and is often used in those studies looking at groups with mental illness. 8,9,22,24,25,30,33,42,45,49,50 The RTQL assesses current smokers' Stage of Change for smoking cessation as follows: action (actively cutting down or quit recently), preparatory (desire to quit in the next 30 days), contemplative (desire to quit in the next 6 months), and precontemplative (no timeline or not interested). 43 The DBCS is a 20-item scale measuring smokers' perceptions of positive and negative attributes of smoking.…”

Section: Instrumentsmentioning

confidence: 99%

“…Ability to generalize previous findings to Canadian acute-care psychiatric inpatients is uncertain, as samples have often involved chronically institutionalized populations, specific diagnostic groups or specialized care units, or countries with a greater prevalence of smoking in the general population. 8,11,[20][21][22][23][24][25][26][27] One Canadian survey at a provincial psychiatric hospital involving long stay patients found smoking rates of 62.7% for patients with schizophrenia, 28 while another Canadian mixed inpatient-outpatient study found that a large proportion (40%) of patients with schizophrenia who smoke were interested in quitting. 29 To our knowledge, there have been no Canadian studies evaluating the prevalence of cigarette smoking and nicotine dependence or motivation for smoking cessation among patients typically admitted to general acute-care psychiatric inpatient units.…”

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confidence: 99%

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Cigarette Smoking, Nicotine Dependence, and Motivation for Smoking Cessation in Psychiatric Inpatients

et al. 2009

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Objective: Cigarette smoking is the leading preventable cause of death and disease in Canada, and is disproportionately more frequent among psychiatric patients. Smoking cessation interventions can be successfully implemented with psychiatric patients, yet no Canadian studies have evaluated smoking prevalence, nicotine dependence, and motivation for smoking cessation in psychiatric inpatients. Our study did so to help plan appropriate interventions for these patients. Method: All inpatients aged 18 years or older admitted to acute-care psychiatry units at the Foothills Medical Centre in Calgary, Alberta, during a 6-month period completed a survey involving questions from the Canadian Tobacco Use Monitoring Survey, the Fagerstrom Test for Nicotine Dependence (FTND), the Readiness to Quit Ladder, and the Decisional Balance for Cigarette Smoking. Responses were analyzed for correlation with discharge diagnoses, age, and sex. Results: Among the total inpatients (n = 342), 211 (62%) completed the survey. Among those, 55% were current cigarette smokers and 17.5% were former smokers. Nicotine dependence (FTND ³ 6) was reported in 45.2% of smokers. Smoking prevalence and nicotine dependence severity was greatest in the substance use disorders (SUD) and psychotic disorders groups. Current smokers endorsed more negative than positive attributes of smoking. Regarding smoking cessation, 51% of patients were precontemplative, 12.7% contemplative, and 36.2% preparatory or action-oriented, despite few receiving advice to quit. Conclusions: Cigarette smoking and nicotine dependence are highly prevalent in psychiatric inpatients. However, self-reported motivation for smoking cessation is noteworthy, emphasizing that cessation advice and appropriate follow-up care should be provided to psychiatric inpatients who smoke.

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Section: Discussionmentioning

confidence: 95%

Section: Instrumentsmentioning

confidence: 99%

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confidence: 99%

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Cigarette Smoking, Nicotine Dependence, and Motivation for Smoking Cessation in Psychiatric Inpatients

et al. 2009

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“…Nicotine also improves diseaseassociated deficits in prepulse inhibition (PPI) of the acoustic startle response (Kumari et al, 2001) and oculomotor function, with improvements reported in smooth pursuit eye movement (SPEM) and antisaccade error rates (Olincy et al, 1998(Olincy et al, , 2003Depatie et al, 2002;Sherr et al, 2002;Avila et al, 2003). These findings, combined with the observation that the prevalence of cigarette smoking is much higher in schizophrenia compared with the general population, (Hughes, 1986;de Leon et al, 2002) have led to the hypothesis that smoking represents a form of self-medication for patients with psychiatric illness, particularly schizophrenia (Glassman, 1993;Dalack et al, 1998;Kumari and Postma, 2005).…”

Section: Introductionmentioning

confidence: 98%

The Effects of Transdermal Nicotine on Cognition in Nonsmokers with Schizophrenia and Nonpsychiatric Controls

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Culhane

Jubelt

et al. 2007

Neuropsychopharmacol

215

151

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Abundant evidence indicates that the neuronal nicotinic acetylcholine receptor (nAChR) system is integral to regulation of attentional processes and is dysregulated in schizophrenia. Nicotinic agonists may have potential for the treatment of cognitive impairment in this disease. This study investigated the effects of transdermal nicotine on attention in individuals with schizophrenia (n ¼ 28) and healthy controls (n ¼ 32). All participants were nonsmokers in order to eliminate confounding effects of nicotine withdrawal and reinstatement that may occur in the study of smokers. Subjects received 14 mg transdermal nicotine and identical placebo in a randomized, placebocontrolled, crossover design. A cognitive battery was conducted before and 3 h after each patch application. The primary outcome measure was performance on the Continuous Performance Test Identical Pairs (CPT-IP) Version. Nicotine significantly improved the performance on the CPT-IP as measured by hit reaction time, hit reaction time standard deviation and random errors in both groups. In addition, nicotine reduced commission errors on the CPT-IP and improved the performance on a Card Stroop task to a greater extent in those with schizophrenia vs controls. In summary, nicotine improved attentional performance in both groups and was associated with greater improvements in inhibition of impulsive responses in subjects with schizophrenia. These results confirm previous findings that a single dose of nicotine improves attention and suggest that nicotine may specifically improve response inhibition in nonsmokers with schizophrenia.

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“…1,2 Their dependence on nicotine is approximately three times that of the general population with a prevalence reaching almost 90%. 3 Investigations of smoking behaviour among schizophrenia patients have shown that they smoke more, exhibit stronger addictive behaviours and encounter more difficulties with smoking cessation compared to healthy cigarette consumers.…”

Section: Introductionmentioning

confidence: 99%

Differential effects on T-cell function following exposure to serum from schizophrenia smokers

et al. 2008

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Cigarette smoking is more prevalent in subjects with schizophrenia compared to those with other psychiatric disorders or the general population and could therefore affect molecular pathways that impact the pathophysiology of this disorder. As smoking is also known to suppress immune responses, we investigated the effects of 'smoking-conditioned' serum obtained from schizophrenia and control subjects on healthy T cell in vitro. We found that T-cell proliferation was significantly increased following exposure to serum from smoking schizophrenia patients whereas no effect was observed when using serum from smoking control subjects or non-smoking patients and controls. We eliminated the possibility that these effects were due to quantitative differences in cigarette consumption as serum levels of the stable nicotine metabolite cotinine were similar in schizophrenic and control smokers. Molecular characterization showed that serum from patient smokers increased expression of T-cell activation markers CD69 high , CD25 high , co-stimulatory molecules CD26 þ , CD27 þ and CD28 þ , and decreased T-cell receptor complex components TCRa/b and CD3. Moreover, analysis of supernatants collected after T-cell exposure to serum from smoking patients showed a time-dependent decline in interleukin (IL)-2 levels, suggesting that the proliferation effect is promoted by enhanced IL-2 processing. These results suggest that cigarette smoking has selective effects on serum components that, in turn, lead to altered immune function in schizophrenia patients relative to healthy subjects. Further studies aimed at characterizing these components could result in a better understanding of the onset and aetiology of schizophrenia and potentially lead to novel therapeutic strategies.

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Initiation of daily smoking and nicotine dependence in schizophrenia and mood disorders

Cited by 148 publications

References 9 publications

Cigarette Smoking, Nicotine Dependence, and Motivation for Smoking Cessation in Psychiatric Inpatients

Cigarette Smoking, Nicotine Dependence, and Motivation for Smoking Cessation in Psychiatric Inpatients

The Effects of Transdermal Nicotine on Cognition in Nonsmokers with Schizophrenia and Nonpsychiatric Controls

Differential effects on T-cell function following exposure to serum from schizophrenia smokers

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