Smoking alleviates psychiatric symptoms

Smoking cigarettes seems to have a positive effect on some of the cognitive symptoms of schizophrenia

Dr. Paul LatimerSome of you might be wondering exactly what smoking has to do with psychiatric illness or mental health at all. You’re not alone; this topic has not been widely discussed or considered in psychiatric circles until fairly recently. However, as new research emerges it becomes clear that the two subjects are more linked than we often imagine.

What has come to light is that people with psychiatric conditions are far more likely to smoke than the general population. In fact, approximately 60 per cent of people who experience a psychiatric condition are smokers compared with 25 per cent of the general population.

It has been estimated that 30 per cent of smokers in North America also have a psychiatric condition.

While this fact in itself is astonishing, it has also been discovered that people with psychiatric conditions have a much harder time quitting smoking than those without psychiatric illness.

Until fairly recently, these numbers were insignificant because of society’s more accepting attitude toward smoking in general. As attitudes change and societal pressure to quit smoking increases, it becomes more and more clear that a large group of the smoking population is having a harder time kicking the habit than most.

Most alarming are the numbers of people with schizophrenia or depression who smoke and have a difficult time quitting.

It is estimated that 70 per cent of people with schizophrenia also smoke. Studies have shown that cigarette smoking seems to have a positive effect on some of the cognitive symptoms of schizophrenia. Attempting to quit smoking can worsen these symptoms.

Similarly, as many as 76 per cent of people with depression say they have smoked at some point in their lives. People with a history of depression also seem to have a hard time quitting smoking. Very often, after stopping the use of tobacco, this group will experience a recurrence of depressive symptoms. This usually ends the attempt at smoking cessation.

The same phenomena are often found in people with other psychiatric illnesses including bipolar disorder, anxiety disorders and attention deficit/hyperactivity disorder (ADD/ADHD). Starting and stopping smoking can cause a bipolar patient to experience a manic episode. Smoking also seems to have anti-anxiety effects as well as helping people to focus a little more. Often, people use cigarettes in part to self-medicate even if they aren’t aware of it.

It is unknown exactly how tobacco improves psychiatric symptoms, but there are a number of theories. It is known that nicotine stimulates the release of a number of chemical messengers (called neurotransmitters) in the body, some of which may be the same ones affected by active psychiatric medication.

Also, the body has nicotine specific receptors in many areas and there has been extensive research on their location and function. Progress has been made in understanding the biological basis of smoking in the mentally ill but it is a complex subject.

The ill-effects of chronic smoking bring huge costs to health and healthcare and any way we can work to help people break the habit should be considered worthwhile.

Dr. Latimer is president of Okanagan Clinical Trials and a Kelowna psychiatrist.

The views, opinions and positions expressed by columnists and contributors are the author’s alone. They do not inherently or expressly reflect the views, opinions and/or positions of our publication.


7 Responses to "Smoking alleviates psychiatric symptoms"

  1. Avatar
    IroCyZane   April 27, 2015 at 1:26 pm

    And yet psychiatric patients are treated inhumanly in psychiatric facilities as reputable as the CMAH in Toronto, Canada (and probably others) where it is already bad enough that they can’t smoke tobacco in any designated indoor area but not only can they not smoke anywhere outdoors on campus but they can’t even bring their cigarettes back in their lockers causing them to either buy, beg, borrow or steal cigarettes anytime they can go off campus to enjoy one.

  2. Avatar
    orion158   April 27, 2015 at 5:52 pm

    Then there are involuntary mental patients who are not
    permitted outdoors at all. These are completely banned from smoking for however
    long they are held in custody. It’s a form of torture for highly vulnerable
    people. There is a very nasty, cruel streak that has been allowed to flourish in
    the medical establishment….. again… in chasing a questionable ideological
    agenda – the smokefree “utopia”.

  3. Avatar
    orion158   April 27, 2015 at 5:57 pm

    It should be noted that voluntary patients are presenting
    for a particular mental condition. They are not presenting for smoking
    cessation. Involuntary patients are classified as such by a court order that
    requires them to undergo treatment for a particular mental condition. There is
    nothing in the court order about smoking cessation: Smoking is NOT why they
    have been classified as a mental patient. The facility is obliged to only treat
    the condition deemed by the court. It must also be remembered that involuntary mental
    health patients are not criminals.

    If an involuntary patient is asking for a cigarette, they
    obviously don’t want to quit. Forcing smoking cessation on them is going beyond
    the scope of treatment permitted for the patient and violating informed consent
    (either patient or court). It’s bureaucrats and antismoking activist bigots
    terribly messing with vulnerable patients. Mental patients are not some
    experimental quantity whose entire lives are at the complete disposal/whim of
    psychiatrists/bureaucrats. There is very serious misconduct occurring here. The
    problem is that an ideological crusade – the smokefree “utopia” – now trumps
    the humane treatment of patients. It is a cruelty inflicting further distress
    and anguish on mental patients masqueraded as “duty of care”, i.e., iatrogenic.

    Moreover, the “authorities” typically claim that patients
    are “treated” with “nicotine replacement therapy” (NRT) as if this makes their
    position any more tenable, that NRT somehow “solves everything”. In addition to
    the above concerns, NRT is next to useless for people without mental conditions
    that are wanting to quit smoking. NRT is entirely useless for those that do not
    want to quit, let alone that they might also be in a highly distressed mental
    state. Mental patients who smoke, already in a highly distressed state, are
    being forced to quit smoking “cold turkey”. This NRT “treatment” only generates
    sales for pharmaceutical companies. Why would anyone subject mental patients to
    this politically/financially-motivated assault? Why aren’t those in the mental
    health hierarchy aware that NRT is useless? Why do bureaucrats value the mental
    health of patients below maintaining an ideological (antismoking) stance? It is
    those running mental health facilities that are demonstrating some serious
    mental issues. And it wouldn’t be the first time that mental health authorities
    have used/exploited mental patients in a malicious and criminal manner; the
    provision of treatment for mental patients is littered with dark periods where
    the obscene conduct of the “healers” defies sane description.

    In chasing a questionable ideological agenda, a cruel streak
    has again been allowed to proliferate within the mental health hierarchy; it’s
    another “dark” period. A mental patient that smokes is now confronted with a perverse,
    frightening, and destructive cult mentality in the health system that is
    fanatically intent on forcibly “converting” the patient into a nonsmoker. It is
    entirely beyond the scope of necessary/mandated treatment that further
    compromises the mental health of patients. This obscene situation is in urgent
    need of scrutiny, asking how an ideological agenda has been allowed to derail
    the humane and legal provision of mental health services.

  4. Avatar
    IroCyZane   April 27, 2015 at 9:18 pm

    orion158 ‘Why this is happening?  This is a documented big part of the answer for the CAMH in Toronto at least : 
    ”’The Centre for Addiction and Mental Health (CAMH) received $1.4 million from pharmaceutical companies in 2005-2006.”’

    That was back in 2005-2006.  How much are they getting now? 
    Do read the whole article to see how many bribes ooops, sorry I mean grants, were given out to anti-smoking advocate groups.  And this is just the tip of the iceberg and it doesn’t begin talking about how many millions were allotted to anti-smoking groups in the USA and billions throughout the world.

  5. Avatar
    IroCyZane   April 27, 2015 at 9:20 pm

    orion158 “There’s no question that if you’re paying the piper, you influence the tune that the piper is going to play.”

  6. Avatar
    AudreySilk   April 28, 2015 at 1:42 am

    Just. Let. Them. Smoke.  The hysterics over smoking is creating indecent and inhumane consequences.  Smoking has for centuries been normal.  It is still normal.  The campaign against it is what’s not the norm.  The choice between ill mental health or the private choice to smoke?  Really?  Is this what it’s come to? Add malicious to my list of adjectives.

  7. Avatar
    HaroldMaio   April 28, 2015 at 12:50 pm

    …and I have a bridge in Brooklyn I would like to sell.

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