SpringerLink
Log in

Achieving Smoking Cessation in Individuals with Schizophrenia: Special Considerations

  • Review Article
  • Published:
CNS Drugs Aims and scope Submit manuscript

Abstract

Premature mortality due to cardiovascular disease in those with schizophrenia is the largest lifespan disparity in the US and is growing; adults in the US with schizophrenia die, on average, 28 years earlier than those in the general population. The rate of smoking prevalence among individuals with schizophrenia is estimated to be from 64 to 79%. Smokers with schizophrenia have historically been excluded from most large nicotine-dependence treatment studies. However, converging evidence indicates that a majority of smokers with schizophrenia want to quit smoking, and that available pharmacotherapeutic smoking cessation aids are well tolerated by this population of smokers and are effective when combined with behavioral treatment. The aim of this review is to present updated evidence for safety and efficacy of smoking cessation interventions for those with schizophrenia spectrum illness. We also highlight implications of the very low abstinence rates for smokers with schizophrenia who receive placebo plus behavioral treatment in randomized trials, and review treatment approaches to address the high rate of rapid relapse observed upon pharmacologic treatment discontinuation in this population. Recommendations for monitoring for treatment-emergent nicotine withdrawal symptoms, side effects, and effects of cessation on antipsychotic medication are also provided. Smokers with schizophrenia spectrum disorders should be encouraged to quit smoking and should receive varenicline, bupropion with or without nicotine replacement therapy (NRT), or NRT, all in combination with behavioral treatment for at least 12 weeks. Maintenance pharmacotherapy may reduce relapse and improve sustained abstinence rates. Controlled trials in smokers with schizophrenia consistently show no greater rate of neuropsychiatric adverse events with pharmacotherapeutic cessation aids than with placebo.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price includes VAT (Canada)

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. de Leon J, Diaz FJ, Rogers T, Browne D, Dinsmore L. Initiation of daily smoking and nicotine dependence in schizophrenia and mood disorders. Schizophrenia Res. 2002;56(1):47–54.

    Article  Google Scholar 

  2. Olincy A, Young DA, Freedman R. Increased levels of the nicotine metabolite cotinine in schizophrenic smokers compared to other smokers. Biol Psychiatry. 1997;42(1):1–5.

    Article  CAS  PubMed  Google Scholar 

  3. Williams JM, Ziedonis DM, Abanyie F, Steinberg ML, Foulds J, Benowitz NL. Increased nicotine and cotinine levels in smokers with schizophrenia and schizoaffective disorder is not a metabolic effect. Schizophr Res. 2005;79(2):323–35.

    Article  PubMed  Google Scholar 

  4. Williams JM, Gandhi KK, Lu SE, Kumar S, Shen J, Foulds J, et al. Higher nicotine levels in schizophrenia compared with controls after smoking a single cigarette. Nicotine Tob Res. 2010;12(8):855–9.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  5. Tidey JW, Rohsenow DJ, Kaplan GB, Swift RM. Cigarette smoking topography in smokers with schizophrenia and matched non-psychiatric controls. Drug Alcohol Depen. 2005;80(2):259–65.

    Article  Google Scholar 

  6. Wellmann KF. Smoking and health. On the report of the advisory committee to the surgeon general of the public health service. Dtsch Med Wochenschr. 1964;89:1085–6.

    Article  CAS  PubMed  Google Scholar 

  7. Office of the Surgeon General, Office on Smoking and Health. Reports of the surgeon general. The health consequences of smoking: a report of the surgeon general. Atlanta: Centers for Disease Control and Prevention; 2004.

  8. Agaku IT, King BA, Dube SR, Control CfD, Prevention. Current cigarette smoking among adults—United States, 2005–2012. MMWR Morb Mortal Wkly Rep. 2014;63(2):29–34.

    PubMed  Google Scholar 

  9. Le Cook B, Wayne GF, Kafali EN, Liu ZM, Shu C, Flores M. Trends in smoking among adults with mental illness and association between mental health treatment and smoking cessation. JAMA. 2014;311(2):172–82.

    Article  PubMed  Google Scholar 

  10. Dube SR, McClave A, James C, Caraballo R, Kaufmann R, Pechacek T. Vital signs: current cigarette smoking among adults aged ≥18 years—United States, 2009. JAMA. 2010;304(17):1889–91 (Reprinted from MMWR. 2010;59:1135–1140).

    CAS  Google Scholar 

  11. Dickerson F, Stallings CR, Origoni AE, Vaughan C, Khushalani S, Schroeder J, et al. Cigarette smoking among persons with schizophrenia or bipolar disorder in routine clinical settings, 1999–2011. Psychiatr Serv. 2013;64(1):44–50.

    Article  PubMed  Google Scholar 

  12. Hartz SM, Pato CN, Medeiros H, Cavazos-Rehg P, Sobell JL, Knowles JA, et al. Comorbidity of severe psychotic disorders with measures of substance use. JAMA Psychiatry. 2014;71(3):248–54.

    Article  PubMed  PubMed Central  Google Scholar 

  13. Barr RS, Culhane MA, Jubelt LE, Mufti RS, Dyer MA, Weiss AP, et al. The effects of transdermal nicotine on cognition in nonsmokers with schizophrenia and nonpsychiatric controls. Neuropsychopharmacology. 2008;33(3):480–90.

    Article  CAS  PubMed  Google Scholar 

  14. Siru R, Hulse GK, Tait RJ. Assessing motivation to quit smoking in people with mental illness: a review. Addiction. 2009;104(5):719–33.

    Article  PubMed  Google Scholar 

  15. Tidey JW, Rohsenow DJ. Smoking expectancies and intention to quit in smokers with schizophrenia, schizoaffective disorder and non-psychiatric controls. Schizophr Res. 2009;115(2–3):310–6.

    Article  PubMed  PubMed Central  Google Scholar 

  16. Tidey JW, Rohsenow DJ. Intention to quit moderates the effect of bupropion on smoking urge. Nicotine Tobacco Res. 2009;11(3):308–12.

    Article  Google Scholar 

  17. Addington J, elGuebaly N, Addington D, Hodgins D. Readiness to stop smoking in schizophrenia. Can J Psychiatry. 1997;42(1):49–52.

    Article  CAS  PubMed  Google Scholar 

  18. Kelly DL, Raley HG, Lo S, Wright K, Liu F, McMahon RP, et al. Perception of smoking risks and motivation to quit among nontreatment-seeking smokers with and without schizophrenia. Schizophr Bull. 2012;38(3):543–51.

    Article  PubMed  Google Scholar 

  19. Olfson M, Gerhard T, Huang C, Crystal S, Stroup TS. Premature mortality among adults with schizophrenia in the United States. JAMA Psychiatry. 2015;72(12):1172–81.

    Article  PubMed  Google Scholar 

  20. Brown S, Inskip H, Barraclough B. Causes of the excess mortality of schizophrenia. Br J Psychiatry. 2000;177:212–7.

    Article  CAS  PubMed  Google Scholar 

  21. Goff DC, Cather C, Evins AE, Henderson DC, Freudenreich O, Copeland PM, et al. Medical morbidity and mortality in schizophrenia: guidelines for psychiatrists. J Clin Psychiatry. 2005;66(2):183–94 (quiz 47, 273–4).

    Article  PubMed  Google Scholar 

  22. Mokdad AH, Marks JS, Stroup DF, Gerberding JL. Actual causes of death in the United States, 2000. JAMA. 2004;291(10):1238–45.

    Article  PubMed  Google Scholar 

  23. Danaei G, Ding EL, Mozaffarian D, Taylor B, Rehm J, Murray CJ, et al. The preventable causes of death in the United States: comparative risk assessment of dietary, lifestyle, and metabolic risk factors. PLoS Med. 2009;6(4):e1000058.

    Article  PubMed  PubMed Central  Google Scholar 

  24. Callaghan RC, Veldhuizen S, Jeysingh T, Orlan C, Graham C, Kakouris G, et al. Patterns of tobacco-related mortality among individuals diagnosed with schizophrenia, bipolar disorder, or depression. J Psychiatr Res. 2014;48(1):102–10.

    Article  PubMed  Google Scholar 

  25. Jha P, Ramasundarahettige C, Landsman V, Rostron B, Thun M, Anderson RN, et al. 21st-century hazards of smoking and benefits of cessation in the United States. N Engl J Med. 2013;368(4):341–50.

    Article  CAS  PubMed  Google Scholar 

  26. Pirie K, Peto R, Reeves GK, Green J, Beral V, Million Women Study C. The 21st century hazards of smoking and benefits of stop**: a prospective study of one million women in the UK. Lancet. 2013;381(9861):133–41.

    Article  PubMed  PubMed Central  Google Scholar 

  27. Thorndike AN, Achtyes ED, Cather C, Pratt S, Pachas GN, Hoeppner SS, et al. Weight gain and 10-year cardiovascular risk with sustained tobacco abstinence in smokers with serious mental illness: a subgroup analysis of a randomized trial. J Clin Psychiatry. 2016;77(3):e320–6.

    Article  PubMed  Google Scholar 

  28. Huang Y, Lewis S, Britton J. Use of varenicline for smoking cessation treatment in UK primary care: an association rule mining analysis. BMC Public Health. 2014;14:1024.

    Article  PubMed  PubMed Central  Google Scholar 

  29. Mitchell AJ, Vancampfort D, De Hert M, Stubbs B. Do people with mental illness receive adequate smoking cessation advice? A systematic review and meta-analysis. Gen Hosp Psychiatry. 2015;37(1):14–23.

    Article  PubMed  Google Scholar 

  30. Evins A BN, West R, Russ C, McRae T, Lawrence D, St. Aubin L, Ascher J, Krishen A, Anthenelli RM. Neuropsychiatric safety and efficacy of varenicline and bupropion vs. nicotine patch and placebo in the psychiatric cohort of the EAGLES trial. Society for Research on Nicotine and Tobacco, 22nd Annual Meeting, 2016, Chicago, IL.

  31. Tsoi DT, Porwal M, Webster AC. Interventions for smoking cessation and reduction in individuals with schizophrenia. Cochrane Database Syst Rev. 2013;2(2):CD007253

  32. Huang Y, Britton J, Hubbard R, Lewis S. Who receives prescriptions for smoking cessation medications? An association rule mining analysis using a large primary care database. Tob Control. 2013;22(4):274–9.

    Article  PubMed  Google Scholar 

  33. Williams JM, Willett JG, Miller G. Partnership between tobacco control programs and offices of mental health needed to reduce smoking rates in the United States. JAMA Psychiatry. 2013;70(12):1261–2.

    Article  PubMed  Google Scholar 

  34. Schroeder SA, Morris CD. Confronting a neglected epidemic: tobacco cessation for persons with mental illnesses and substance abuse problems. Annu Rev Public Health. 2010;31:297–314 (1p following 314).

    Article  PubMed  Google Scholar 

  35. Evins AE. Reassessing the safety of varenicline. Am J Psychiatry. 2013;170(12):1385–7.

    Article  PubMed  Google Scholar 

  36. Brody AL, Zorick T, Hubert R, Hellemann GS, Balali S, Kawasaki SS, et al. Combination extended smoking cessation treatment plus home visits for smokers with schizophrenia: a randomized controlled trial. Nicotine Tob Res. 2017;19(1):68–76.

    Article  PubMed  Google Scholar 

  37. Buchanan RW, Kreyenbuhl J, Kelly DL, Noel JM, Boggs DL, Fischer BA, et al. The 2009 schizophrenia PORT psychopharmacological treatment recommendations and summary statements. Schizophr Bull. 2010;36(1):71–93.

    Article  PubMed  Google Scholar 

  38. George TP, Vessicchio JC, Termine A, Bregartner TA, Feingold A, Rounsaville BJ, et al. A placebo controlled trial of bupropion for smoking cessation in schizophrenia. Biol Psychiatry. 2002;52(1):53–61.

    Article  CAS  PubMed  Google Scholar 

  39. Evins AE, Cather C, Culhane MA, Birnbaum A, Horowitz J, Hsieh E, et al. A 12-week double-blind, placebo-controlled study of bupropion sr added to high-dose dual nicotine replacement therapy for smoking cessation or reduction in schizophrenia. J Clin Psychopharmacol. 2007;27(4):380–6.

    Article  CAS  PubMed  Google Scholar 

  40. Evins AE, Cather C, Deckersbach T, Freudenreich O, Culhane MA, Olm-Shipman CM, et al. A double-blind placebo-controlled trial of bupropion sustained-release for smoking cessation in schizophrenia. J Clin Psychopharm. 2005;25(3):218–25.

    Article  CAS  Google Scholar 

  41. Evins AE, Cather C, Pratt SA, Pachas GN, Hoeppner SS, Goff DC, et al. Maintenance treatment with varenicline for smoking cessation in patients with schizophrenia and bipolar disorder: a randomized clinical trial. JAMA. 2014;311(2):145–54.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  42. George TP, Vessicchio JC, Sacco KA, Weinberger AH, Dudas MM, Allen TM, et al. A placebo-controlled trial of bupropion combined with nicotine patch for smoking cessation in schizophrenia. Biol Psychiatry. 2008;63(11):1092–6.

    Article  CAS  PubMed  Google Scholar 

  43. Williams JM, Anthenelli RM, Morris CD, Treadow J, Thompson JR, Yunis C, et al. A randomized, double-blind, placebo-controlled study evaluating the safety and efficacy of varenicline for smoking cessation in patients with schizophrenia or schizoaffective disorder. J Clin Psychiatry. 2012;73(5):654–60.

    Article  CAS  PubMed  Google Scholar 

  44. Weiner E, Buchholz A, Coffay A, Liu F, McMahon RP, Buchanan RW, et al. Varenicline for smoking cessation in people with schizophrenia: a double blind randomized pilot study. Schizophr Res. 2011;129(1):94–5.

    Article  PubMed  PubMed Central  Google Scholar 

  45. Anthenelli RM, Benowitz NL, West R, St Aubin L, McRae T, Lawrence D, et al. Neuropsychiatric safety and efficacy of varenicline, bupropion, and nicotine patch in smokers with and without psychiatric disorders (EAGLES): a double-blind, randomised, placebo-controlled clinical trial. Lancet. 2016;387(10037):2507–20.

    Article  CAS  PubMed  Google Scholar 

  46. Fiore MC, Jaen CR, Baker TB, Bailey WC, Benowitz NL, Curry SJ, et al. Treating tobacco use and dependence: 2008 update US Public Health Service Clinical Practice Guideline executive summary. Resp Care. 2008;53(9):1217–22.

    Google Scholar 

  47. Cahill K, Stevens S, Lancaster T. Pharmacological treatments for smoking cessation. JAMA. 2014;311(2):193–4.

    Article  CAS  PubMed  Google Scholar 

  48. Weiner E, Ball MP, Buchholz AS, Gold JM, Evins AE, McMahon RP, et al. Bupropion sustained release added to group support for smoking cessation in schizophrenia: a new randomized trial and a meta-analysis. J Clin Psychiatry. 2012;73(1):95–102.

    Article  CAS  PubMed  Google Scholar 

  49. Evins AE, Cather C, Laffer A. Treatment of tobacco use disorders in smokers with serious mental illness: toward clinical best practices. Harvard Rev Psychiatry. 2015;23(2):90–8.

    Article  Google Scholar 

  50. Tidey JW, Miller ME. Smoking cessation and reduction in people with chronic mental illness. BMJ. 2015;351:h4065.

    Article  PubMed  PubMed Central  Google Scholar 

  51. Evins AE, Cather C, Deckersbach T, Freudenreich O, Culhane MA, Olm-Shipman CM, et al. A double-blind placebo-controlled trial of bupropion sustained-release for smoking cessation in schizophrenia. J Clin Psychopharmacol. 2005;25(3):218–25.

    Article  CAS  PubMed  Google Scholar 

  52. Evins AE BN, West R, Russ C, McRae T, Lawrence D, St. Aubin L, Ascher J, Krishen A, Anthenelli RM. Neuropsychiatric safety and efficacy of varenicline and bupropion vs. nicotine patch and placebo in the psychiatric cohort of the EAGLES trial. Society for Research on Nicotine and Tobacco, 22nd Annual Meeting, 2016, Chicago, IL.

  53. Evins AE, Hoeppner SS, Schoenfeld DA, Hoeppner BB, Cather C, Pachas GN, et al. Maintenance pharmacotherapy normalizes the relapse curve in recently abstinent tobacco smokers with schizophrenia and bipolar disorder. Schizophr Res. (Epub 9 Dec 2016).

  54. Anthenelli RM, Morris C, Ramey TS, Dubrava SJ, Tsilkos K, Russ C, et al. Effects of varenicline on smoking cessation in adults with stably treated current or past major depression: a randomized trial. Ann Intern Med. 2013;159(6):390–400.

    Article  PubMed  Google Scholar 

  55. Chengappa KN, Perkins KA, Brar JS, Schlicht PJ, Turkin SR, Hetrick ML, et al. Varenicline for smoking cessation in bipolar disorder: a randomized, double-blind, placebo-controlled study. J Clin Psychiatry. 2014;75(7):765–72.

    Article  CAS  PubMed  Google Scholar 

  56. Wu BS, Weinberger AH, Mancuso E, Wing VC, Haji-Khamneh B, Levinson AJ, et al. A preliminary feasibility study of varenicline for smoking cessation in bipolar disorder. J Dual Diagn. 2012;8(2):131–2.

    Article  PubMed  PubMed Central  Google Scholar 

  57. Pachas GN, Cather C, Pratt SI, Hoeppner B, Nino J, Carlini SV, et al. Varenicline for smoking cessation in schizophrenia: safety and effectiveness in a 12-week open-label trial. J Dual Diagn. 2012;8(2):117–25.

    Article  PubMed  PubMed Central  Google Scholar 

  58. Gibbons RD, Mann JJ. Varenicline, smoking cessation, and neuropsychiatric adverse events. Am J Psychiatry. 2013;170(12):1460–7.

    Article  PubMed  PubMed Central  Google Scholar 

  59. Cather C, Dyer MA, Burrell HA, Hoeppner B, Goff DC, Evins AE. An open trial of relapse prevention therapy for smokers with schizophrenia. J Dual Diagn. 2013;9(1):87–93.

    Article  PubMed  PubMed Central  Google Scholar 

  60. Horst WD, Klein MW, Williams D, Werder SF. Extended use of nicotine replacement therapy to maintain smoking cessation in persons with schizophrenia. Neuropsychiatr Dis Treatm. 2005;1(4):349.

    CAS  Google Scholar 

  61. Breese CR, Lee MJ, Adams CE, Sullivan B, Logel J, Gillen KM, et al. Abnormal regulation of high affinity nicotinic receptors in subjects with schizophrenia. Neuropsychopharmacol Off Publ Am Coll Neuropsychopharmacol. 2000;23(4):351–64.

    Article  CAS  Google Scholar 

  62. Freedman R, Adler LE, Leonard S. Alternative phenotypes for the complex genetics of schizophrenia. Biol Psychiatry. 1999;45(5):551–8.

    Article  CAS  PubMed  Google Scholar 

  63. Culhane MA, Schoenfeld DA, Barr RS, Cather C, Deckersbach T, Freudenreich O, et al. Predictors of early abstinence in smokers with schizophrenia. J Clin Psychiatry. 2008;69(11):1743–50.

    Article  PubMed  PubMed Central  Google Scholar 

  64. Schuster RM, Cather C, Pachas GN, Zhang H, Cieslak KM, Hoeppner SS, et al. Predictors of tobacco abstinence in outpatient smokers with schizophrenia or bipolar disorder treated with varenicline and cognitive behavioral smoking cessation therapy. Addict Behav. 2017;71:89–95.

    Article  PubMed  Google Scholar 

  65. George TP, Ziedonis DM, Feingold A, Pepper WT, Satterburg CA, Winkel J, et al. Nicotine transdermal patch and atypical antipsychotic medications for smoking cessation in schizophrenia. Am J Psychiatry. 2000;157(11):1835–42.

    Article  CAS  PubMed  Google Scholar 

  66. Tonstad S, Tonnesen P, Hajek P, Williams KE, Billing CB, Reeves KR, et al. Effect of maintenance therapy with varenicline on smoking cessation: a randomized controlled trial. JAMA. 2006;296(1):64–71.

    Article  CAS  PubMed  Google Scholar 

  67. Hughes JR, Hatsukami D. Signs and symptoms of tobacco withdrawal. Arch Gen Psychiatry. 1986;43(3):289–94.

    Article  CAS  PubMed  Google Scholar 

  68. Tidey JW, Colby SM, Xavier EM. Effects of smoking abstinence on cigarette craving, nicotine withdrawal, and nicotine reinforcement in smokers with and without schizophrenia. Nicotine Tob Res. 2014;16(3):326–34.

    Article  CAS  PubMed  Google Scholar 

  69. Reference. PsD. Varenicline—drug summary. 2017. http://www.chantix.com. Accessed 27 Jan 2017.

  70. Hughes JR, Rennard SI, Fingar JR, Talbot SK, Callas PW, Fagerstrom KO. Efficacy of varenicline to prompt quit attempts in smokers not currently trying to quit: a randomized placebo-controlled trial. Nicotine Tob Res. 2011;13(10):955–64.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  71. Rennard S, Hughes J, Cinciripini PM, Kralikova E, Raupach T, Arteaga C, et al. A randomized placebo-controlled trial of varenicline for smoking cessation allowing flexible quit dates. Nicotine Tob. 2012;14(3):343–50.

    Article  CAS  Google Scholar 

  72. Zevin S, Benowitz NL. Drug interactions with tobacco smoking. An update. Clin Pharmacokinet. 1999;36(6):425–38.

    Article  CAS  PubMed  Google Scholar 

  73. Schrenk D, Brockmeier D, Morike K, Bock KW, Eichelbaum M. A distribution study of CYP1A2 phenotypes among smokers and non-smokers in a cohort of healthy Caucasian volunteers. Eur J Clin Pharmacol. 1998;53(5):361–7.

    Article  CAS  PubMed  Google Scholar 

  74. Dalack GW, Becks L, Hill E, Pomerleau OF, Meador-Woodruff JH. Nicotine withdrawal and psychiatric symptoms in cigarette smokers with schizophrenia. Neuropsychopharmacology. 1999;21(2):195–202.

    Article  CAS  PubMed  Google Scholar 

  75. Kleber H, Weiss R, Anton R Jr, George T, Greenfield S, Kosten T. Steering Committee on Practice Guidelines. Treatment of patients with substance use disorders. Am J Psychiatry. 2007;164(4 Suppl):5–123.

    PubMed  Google Scholar 

  76. Desai HD, Seabolt J, Jann MW. Smoking in patients receiving psychotropic medications: a pharmacokinetic perspective. CNS Drugs. 2001;15(6):469–94.

    Article  CAS  PubMed  Google Scholar 

  77. Tidey JW, Cassidy RN, Miller ME. Smoking topography characteristics of very low nicotine content cigarettes, with and without nicotine replacement, in smokers with schizophrenia and controls. Nicotine Tob Res. 2016;18(9):1807–12.

    Article  PubMed  Google Scholar 

  78. Dixon LB, Dickerson F, Bellack AS, Bennett M, Dickinson D, Goldberg RW, et al. The 2009 schizophrenia PORT psychosocial treatment recommendations and summary statements. Schizophr Bull. 2010;36(1):48–70.

    Article  PubMed  Google Scholar 

  79. Duffy SA, Munger A, Karvonen-Gutierrez CA, Piette JD, Kao TA, Veterans Integrated Service Network 11 Tobacco Tactics T. Post-discharge tobacco cessation rates among hospitalized US veterans with and without diabetes. Diabet Med. 2012;29(7):e96–101.

    Article  CAS  PubMed  Google Scholar 

  80. Steinberg ML, Williams JM, Ziedonis DM. Financial implications of cigarette smoking among individuals with schizophrenia. Tob Control. 2004;13(2):206.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  81. Steinberg ML, Williams JM, Stahl NF, Budsock PD, Cooperman NA. An adaptation of motivational interviewing increases quit attempts in smokers with serious mental illness. Nicotine Tob Res. 2016;18(3):243–50.

    Article  PubMed  Google Scholar 

  82. Cather C, Freidman-Yakoobian M, Gottlieb J, Park E, Goff D, Henderson D (eds). A randomized controlled trial of motivational interviewing compared to psychoeducation for smoking pre-contemplators with severe mental illness. Society for Research on Nicotine and Tobacco 16th Annual Meeting Proceedings. Baltimore: Society for Research on Nicotine and Tobacco; 2010.

  83. Ebbert JO, Hughes JR, West RJ, Rennard SI, Russ C, McRae TD, et al. Effect of varenicline on smoking cessation through smoking reduction: a randomized clinical trial. JAMA. 2015;313(7):687–94.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  84. Ruther T, Bobes J, De Hert M, Svensson TH, Mann K, Batra A, et al. EPA guidance on tobacco dependence and strategies for smoking cessation in people with mental illness. Eur Psychiatry. 2014;29(2):65–82.

    Article  CAS  PubMed  Google Scholar 

  85. Garcia-Portilla MP, Bobes J. Smoking cessation programs for persons with schizophrenia: an urgent unmet need. Rev Psiquiatr Salud Ment. 2016;9(4):181–4.

    Article  PubMed  Google Scholar 

  86. De Hert M, Cohen D, Bobes J, Cetkovich-Bakmas M, Leucht S, Ndetei DM, et al. Physical illness in patients with severe mental disorders. II. Barriers to care, monitoring and treatment guidelines, plus recommendations at the system and individual level. World Psychiatry. 2011;10(2):138–51.

    Article  PubMed  Google Scholar 

  87. Liberman JN, Lichtenfeld MJ, Galaznik A, Mastey V, Harnett J, Zou KH, et al. Adherence to varenicline and associated smoking cessation in a community-based patient setting. J Manag Care Pharm. 2013;19(2):125–31.

    PubMed  Google Scholar 

  88. Tidey JW. Using incentives to reduce substance use and other health risk behaviors among people with serious mental illness. Prev Med. 2012;55(Suppl):S54–60.

    Article  PubMed  Google Scholar 

  89. Tidey JW, Rohsenow DJ, Kaplan GB, Swift RM, Reid N. Effects of contingency management and bupropion on cigarette smoking in smokers with schizophrenia. Psychopharmacology (Berl). 2011;217(2):279–87.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  90. Gallagher SM, Penn PE, Schindler E, Layne W. A comparison of smoking cessation treatments for persons with schizophrenia and other serious mental illnesses. J Psychoactive Drugs. 2007;39(4):487–97.

    Article  PubMed  Google Scholar 

  91. Druss BG, Bradford WD, Rosenheck RA, Radford MJ, Krumholz HM. Quality of medical care and excess mortality in older patients with mental disorders. Arch Gen Psychiatry. 2001;58(6):565–72.

    Article  CAS  PubMed  Google Scholar 

  92. Himelhoch S, Daumit G. To whom do psychiatrists offer smoking-cessation counseling? Am J Psychiatry. 2003;160(12):2228–30.

    Article  PubMed  Google Scholar 

  93. Ziedonis D, Hitsman B, Beckham J, Zvolensky M, Adler L, Audrain-McGovern J, et al. Tobacco use and cessation in psychiatric disorders: National Institute of Mental Health report. Nicotine Tob Res. 2008;10(12):1691–715.

    Article  PubMed  Google Scholar 

  94. Heffner JL, Anthenelli RM. Strategies to help patients break the chains of tobacco addiction: evidence-based treatments can help patients quit despite psychiatric illness. Curr Psychiatry. 2011;10(8):41.

    Google Scholar 

  95. Lasser K, Boyd JW, Woolhandler S, Himmelstein DU, McCormick D, Bor DH. Smoking and mental illness: a population-based prevalence study. JAMA. 2000;284(20):2606–10.

    Article  CAS  PubMed  Google Scholar 

  96. Parks J, Svendsen D, Singer P, Foti ME, Mauer B. Morbidity and mortality in people with serious mental illness. Alexandria: National Association of State Mental Health Program Directors (NASMHPD) Medical Directors Council; 2006. p. 25.

    Google Scholar 

  97. Evins AE, Mays VK, Rigotti NA, Tisdale T, Cather C, Goff DC. A pilot trial of bupropion added to cognitive behavioral therapy for smoking cessation in schizophrenia. Nicotine Tob Res. 2001;3(4):397–403.

Download references

Author information

Authors and Affiliations

  1. Department of Psychiatry, Center for Addiction Medicine, Massachusetts General Hospital, 60 Staniford Street, Boston, MA, 02114, USA

    Corinne Cather, Gladys N. Pachas, Kristina M. Cieslak & A. Eden Evins

  2. Schizophrenia Program, Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA

    Corinne Cather, Kristina M. Cieslak & A. Eden Evins

Authors
  1. Corinne Cather
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Gladys N. Pachas
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Kristina M. Cieslak
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. A. Eden Evins
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Corinne Cather.

Ethics declarations

Funding

This work was funded by NIDA K24 DA030443 awarded to Dr. A. Eden Evins.

Conflict of interest

Dr. Evins has received research grants and materials from Pfizer Inc., GlaxoSmithKline, and Forum Pharmaceuticals, and has received honoraria for advisory work from Pfizer Inc. and Reckitt Benckiser. Corinne Cather, Gladys Pachas, and Kristina Cieslak declare no conflicts of interest.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Cather, C., Pachas, G.N., Cieslak, K.M. et al. Achieving Smoking Cessation in Individuals with Schizophrenia: Special Considerations. CNS Drugs 31, 471–481 (2017). https://doi.org/10.1007/s40263-017-0438-8

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s40263-017-0438-8

Search

Navigation