While nationally, only about 20% of Americans smoke, 80% of schizophrenic Americans smoke. That’s interesting, but it’s not the most interesting part. Apparently, there’s some evidence that those people with schizophrenia are using tobacco as a form of self medication.
At the Risk Science Blog, Mark Stewart looks at the weird dilemma people with schizophrenia are faced with when it comes to smoking:
Schizophrenics often have auditory hallucinations, paranoia, delusions, and disorganized thinking. These symptoms are predominantly caused by the inability of the brains of schizophrenics to differentiate, sort, and focus on the multitude of stimuli that go on around us. Think of being in a busy restaurant. Imagine that instead of being able to block out all the noises, conversations, and movements around you, every single piece of sensory information is as important as the interesting things said by the attractive person sitting across from you. The effects of cigarette smoking and nicotine help schizophrenics through increased selective attention.
“They should use other forms of medication,” I hear you say. Great idea, except for the fact that anti-psychotic drugs are very expensive, do not work very well for most people, and have extreme side effects. Tardive dyskinesia is the most common side effect. This makes it very hard for the body to move in normal ways at normal speeds. Also, there are common metabolic side effects that are quite similar to an individual having diabetes. (Just what someone with a severe mental illness needs!) Thus, the cheapness, effectiveness, and availability of cigarettes offer most schizophrenics some succor. Smoking leads to schizophrenics having a 30-60% increased risk of respiratory disorders and heart disease, but is this a risk that is worth taking?
Nicotine is actually a pretty wonderful drug, making one more capable at any tasks. So I am not surprised that it is being used to self-medicate for a variety of mental illnesses.
But cigarettes are not the treatment.
It is the delivery system than causes the problem. So, does putting someone on nicotine patches reduce their mental illnesses? If so, then they should all be prescribed nicotine as a first treatment.
Of course,nicotine is one of the most addictive chemicals around but for a very good reason. It appears to help neural function. I am not sure if there are any proven long term problems with properly dosed nicotine, at least not compared with schizophrenia.