Schizophrenia and smoking

[Xantipius]

http://en.wikipedia.org/wiki/Schizophrenia_and_smoking

Studies across 20 countries show a strong association between schizophrenia and smoking.[1] For example, in the United States, 80% or more of schizophrenics smoke, compared to 20% of the general population in 2006.[2]

Though it is well established that smoking is more prevalent among schizophrenics than the general population as well as those with other psychiatric diagnoses, there is currently no definitive explanation for this difference.[3] Many social, psychological, and biological explanations have been proposed, but today research focuses on neurobiology.

[deceptikon]

Did they break down what exactly was smoked or is it just any kind of burning tobacco constitutes a smoker?

[rant]
I've seen an unfortunate trend in smoking studies to lump pipe and cigar smokers in with cigarette smokers. There's a significant difference between the chemical components of cigarettes and cigars or pipe tobacco. The latter are essentially pure aged tobacco (noting that I'm talking about premium cigars and pipe tobacco), the former have a laundry list of non-tobacco components and extraneous chemicals.

For example, a cigarette has ~100ppb of arsenic while a cigar has ~0.3ppb. Put in perspective, cigarettes have ten times the amount of arsenic allowed in drinking water (10ppb) and cigars have less than 1/10th. CO (carbon monoxide), C6H6 (benzene), C20H12 (benzo[a]pyrene) and NH3 (ammonia) are in both cigarettes and cigars, but their danger is primarily from inhalation.

Cigar and pipe smoke isn't inhaled; cigarette smoke is inhaled. While that means greater risk in terms of mouth, throat, and sinus issues, removing the lungs from the equation is a pretty big deal in smoking related disease risk (which includes heart problems).

Nicotine delivery is completely different as well. Cigarette smoke is more acidic, which makes it difficult to absorb by the mouth and easy to absorb in the lungs without the lungs being overly irritated. Cigars are the opposite: alkaline with strong irritation of the lungs if inhaled and easy absorption by the mouth. Note that inhaled nicotine reaches the brain faster. That might seem like a minor thing but the amount of time between an action and pleasure response contributes to addictiveness.

I won't argue that smoking isn't unhealthy, that would be stupid, but doing a study on cigarette smokers and then attaching the same risks to a completely unrelated class of smokers is either ignorant or intellectually dishonest.
[/rant]

[Troy III]

In poor countries, up to 90% of the population may be smoking!
(yes, I did say "population")

The situation in poor neighborhoods of wealthy states, nonetheless, is not much better!
In fact, it worsens with proximity to the rich parts of a given country -by adding pot to 'the habbit'.

A truly concerned 'citizen of the world' would have tried a study in a truly existing relationship instead.
How a bout "Poverty and Smoking" ?!

[Agilemind]

Why all the negativity? this is a well established correlation. Remember correlation does not imply causation. Schizophrenia may predispose someone to smoke or vice versa, or they may both be caused by a common trigger. Likely it will be some combination or all three. But it doesn't mean being a smoker means your likely to be schizophrenic (schizophrenia is pretty rare so the % of smokers who are schizophrenics is probably almost indistinguishable from the population average).

[Troy III]

First of: I'm no smoker
What is your problem if I may ask - What negativity?
And I don't do drugs either!

And there's Absolutely >>no relation<< between smoking and schizophrenia.
Yet that's exactly what sudoscience wiki-piki article is trying to imply.

But I don't get all that excited about it.
Why so serious?

[adams161]

I had a conversation with a friend maybe eight years ago and this topic came up. He had worked with schizophrenic people as a social worker, something he did for a bit in his twenties. I think he was like a floor staff person at some time of shelter or dependency shelter. He said that all the schizophrenic people he worked with smoked (not sure if he said all or just about all), and as I recall he suggested it was more of a form of self medication. I don't think they were smokers and became schizophrenic from what I gathered he was saying, as much as smoking helped them cope.

[jwenting]

smoking often starts at a young age by aping others, older kids (or parents, TV stars, teachers, etc.) who are smoking, and are looked upon as role models.
Very few people start smoking without such a role model (the foul taste, the acrid smell, of even the first draft on a cigarette (which is how most anyone starts smoking) is enough to put you off for life unless you have a powerful role model you want to personify with).

As schizophrenics are mentally unstable in one way, it's no surprise they're unstable in others and therefore quite possibly more likely to behave such aping behaviour, and less likely to have the mental strength to stop smoking later in life.

[Xantipius]

jwenting, I think this is a much better explanation:

http://www.scientificamerican.com/article.cfm?id=smoking-away-schizophreni

Smoking Away Schizophrenia?

Nicotinelike drugs show promise for alleviating cognitive impairment

By Lisa Conti

Schizophrenia is famous for its symptoms of hallucinations and delusions, but sufferers also face debilitating cognitive impairment—and standard treatments with antipsychotic medications do little to compensate for intellectual loss. Seeking improved mental clarity, many patients turn to a seemingly mundane source: cigarettes. The extraordinarily high incidence of smoking in individuals with schizophrenia—about 85 percent of patients smoke compared with some 20 percent of the general population—has spurred researchers to investigate the therapeutic effects of nicotine in the diseased brain.

Every schizophrenia patient suffers some degree of deficit in memory, attention and thought organization, but no medication currently exists to treat these cognitive impairments. According to patients who smoke, cigarettes alleviate some of these symptoms, but research has found that the effect is short-lived and detrimental to overall health. The receptors to which nicotine binds in the brain quickly become desensitized, rendering smoking ultimately ineffective. And while the positive effects are disappearing, addiction is under way.

As an alternative, researchers are investigating newly derived chemical compounds that bind weakly to the brain’s nicotine receptors. Many of these binding agents are being tested in people who have schizophrenia, Alzheimer’s disease or attention-deficit hyperactivity disorder (ADHD). Although the mechanisms underlying nicotine’s cognitive effects remain unclear, scientists think it might improve focus by enhancing the brain’s ability to filter out unwanted external stimuli. Schizophrenia alters the chemical communication signals used by neurons, making it difficult for the brain to isolate a single process and devote conscious attention to it. Nicotine modifies these signaling processes and may help dampen extraneous neuronal activity.

Schizophrenia expert Carol Tamminga, professor of psychiatry at the University of Texas Southwestern Medical School, says, “Doctors like me hope that in five or 10 years we’ll have medications for different symptom domains. It’s unclear if we’re going to get medications that target specific aspects of cognition, like an attention or memory enhancer specifically, or if we’re going to get drugs that cross the board in a more global way.” But for patients, any treatment would be a welcome relief.

This article was originally published with the title Smoking Away Schizophrenia?.

[Xantipius]

http://www.apa.org/monitor/oct01/melody.aspx

The melody behind mental illness?

October 2001, Vol 32, No. 9

Schizophrenia may be the origin of jazz, according to a theory presented by psychiatrist Sean A. Spence, MD, of the University of Sheffield, at the Royal College of Psychiatrists Annual Meeting in July. Charles "Buddy" Bolden (1877-1931), the man credited with pioneering jazz, had schizophrenia, explains Spence, and due to his condition, he could not properly read music and had impaired motor function. The only way he could play his cornet was by improvising on the ragtime music popular from the 1890s to the 1920s. His lateral thinking influenced many classically trained bands of his time to play more "freewheeling" music with upbeat tempos, beginning the evolution to modern jazz.

Bolden began to show signs of mental illness in 1906, at the height of his popularity, according to jazz writer Fred Ramsey. That same year Bolden attacked his mother in the street and was committed to a mental health institution, where he died in 1931.

--R. BALLIE

[Agilemind]

And there's Absolutely >>no relation<< between smoking and schizophrenia.

Because asserting something on an internet forum instantly makes it true invalidating data collected over dozens of countries and thousands of schizophrenic people.

[greenknight]

It is a well-known correlation, and it's usually attributed to schizophrenics trying to self-medicate. They use other drugs at higher rates as well.

[Agilemind]

Since there is clearly interest in environmental factors in schizophrenia here is a recent review of the science which I think is freely available:

http://schizophreniabulletin.oxfordjournals.org/content/34/6/1066.full

[Stuugie]

I think that if you want to correlate one thing to another, it can be done. What's the solution here, ban smoking completely? That will just create a black market, which is good for no society. Also, as far as science goes, they also used to say that marijuana was the main cause to: becoming gay, males growing breasts, schizophrenia, psychotic behavior, and on and on. Of course, these useless factoids are not true but yet they were believed to be true. I would also like to remind everyone that smokes were given away as prizes on many 50's TV game-shows. When "Doctors Agree" that smoking soothes the throat and calms you after a long day. My how things have changed!

[Agilemind]

What's the solution here, ban smoking completely?

Of course not, for one correlation does not imply causation. Almost all explanations for the smoking-schizophrenia correlation suggest schizophrenia causes smoking (either self-medicating or schizophrenia causes socio-economic conditions which lead to smoking) or that genetics involved in schizophrenia also affect how nicotine is processed making them also more likely to smoke or more strongly addicted once they start.

Also historically, negative effects of something have been undetected/underreported (usually because scaring the public is bad for the economy) not overblown. eg. asbestos, smoking, radiation, etc...

[jwenting]

asbestos and radiation are actually counter examples of your claim, Agilemind. The risks of both have been blown way out of proportion, especially since the 1970s.

In fact the blanket ban on anything called asbestos had as its main sponsor a group of manufacturers of other fire insulation materials, who launched a public scare campaign against asbestos after they themselves had stopped incorporating it into their products because mining of brown and blue asbestos was causing too many cases of asbestosis among the miners (white asbestos is perfectly safe, but was included because the public didn't know the distinction, educating them would be too hard it was considered).

[Agilemind]

asbestos and radiation are actually counter examples of your claim, Agilemind. The risks of both have been blown way out of proportion, especially since the 1970s.

Asbestos is debatable, radiation is certainly true (but is opposed by every radiation/nuclear scientist I know) but I would note that this has only happened long after their discovery & widespread use (same as with tobacco) and it usually involved huge PR battles to get negative effects recognized/accepted.