Cigarette Smoking in Patients with Schizophrenia in Turkey: Relationships to Psychopathology, Socio-Demographic and Clinical Characteristics

Objective: In individuals with schizophrenia, the prevalence of cigarette smoking is significantly higher than that of the general population. This appears to be associated with specific psychosocial and clinical characteristics. However, there is limited data regarding the relationship between smoking and psychopathology, insight, impulsivity, suicidality, hopelessness and depression in patients with schizophrenia. In this regard, the purpose of this study was to examine the relationship between these characteristics and smoking in patients with schizophrenia in Turkey. Method: In this cross-sectional study, 133 outpatients with DSM-IV diagnosis of schizophrenia were recruited and independently interviewed for nicotine dependency with tobacco use. Scale for Assessment of Negative and Positive Symptoms (SANS and SAPS), Calgary Depression Scale for Schizophrenia (CDSS), Beck Hopelessness Scale (BHS), Barrat Impulsivity Scale (BIS), The Yale-Brown Obsessive-Compulsive Scale (YBOCS), Beck Cognitive Insight Scale, Scale of Unawareness of Mental Disorder (SUMD) were used to evaluate related psychopathologic variables. Results: The results revealed that smokers with schizophrenia had higher rates of hospitalization, lifetime suicide attempts, more severe psychopathology, higher impulsivity and hopelessness scores than nonsmokers with schizophrenia. In addition, another important result was that smokers with schizophrenia have higher unemployment rates. Conclusion: From this study, we may gain new insights into the role of cigarette smoking in patients of schizophrenia in Turkey. Our findings suggest that cigarette smoking is associated with not only severe psychopathology but also with impulsivity and hopelessness which are related to suicidality, in patients with schizophrenia. This relationship between suicidality, impulsivity and hopelessness may be of clinical importance for patients with schizophrenia.