Learning Objectives: Recognize significant factors in helping persons with schizophrenia stop or reduce their use of tobacco products.
Abstract:
Problem/Objective: The population of persons with schizophrenia is known to have an exceptionally high prevalence of tobacco use, 80 – 90 %. In addition to addiction, the use of tobacco by this population may be a form of self-medication related to the biology, therapy and symptoms of schizophrenia.
Methods: Approximately 60 volunteers with a diagnosis of schizophrenia or schizo-affective disorder will be enrolled in a 9-month program providing group support and nicotine replacement therapy (NRT) in individually adjusted doses. The efficacy of long term NRT will be determined by comparing placebo with active patches during the final 6 months.
Results: 85% of the subjects rated high or very high on the Fagerstrom nicotine addiction scale. 24% enrolled but failed to attend the group sessions or use NRT. Sixty days into the open label phase, 32% have quit and 34% have significantly reduced (75% or more reduction) their use of tobacco. All participants will have completed the open label phase by July 2003, and the single blind phase by January 2004.
Conclusions: Not only is the prevalence of tobacco use high in this population, but the level of addiction is also high, suggesting that standard approaches to smoking cessation may not be successful. Adjusting individual doses of NRT based on saliva cotinine levels seems to be important in reducing cravings. Participants indicate group support is a key factor to their success. Other factors include financial, personal pride, and feeling better physically.
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