The association between schizophrenia and cigarette smoking: a review of the literature and implications for mental health nursing practice

Despite a fall in smoking activity among the general population, individuals with schizophrenia continue to smoke at alarming rates and suffer poor health as a consequence. It would appear that limited and conflicting knowledge, outdated perceptions, and ineffective interventions have hindered efforts to promote healthy behaviours among this group. This paper reviews the literature on the association between nicotine dependence and schizophrenia and explores explanations for the phenomenon. Complex psychopathological, biochemical, and neuropharmacological interactions between smoking and schizophrenia are revealed. The interface of schizophrenia and smoking behaviour, particularly among those hospitalized in mental health facilities, and rationales for the management of this manifestation are examined. In addition, inferences regarding the role of mental health nurses in the care of this population are reached, and implications for nursing practice are discussed.