‘Doing Things Little by Little’: Smoking and Vaping While Being Pharmaceutically Treated for Schizophrenia

ABSTRACT

This paper explores the experiences of smoking and ‘vaping’ while being pharmaceutically treated for schizophrenia, as well as what the experiences of breathing smoke and vapour in and out can reveal about health ‘care’, toward the self and others. Drawing on ethnographic data collected over 2015–2016 in Australia and the UK, and particularly on patient experiences in the UK where electronic cigarettes had become an endorsed Nicotine Replacement Therapy, I argue that inhaling nicotine via e-cigarettes can, like tobacco cigarettes, be experienced in terms of temporal opportunities for self-reclamation and experiences of health. When patients opted to vape instead of smoke, their sense of self-reclamation allowed for shifted attention toward the movement and materiality of exhalations, and toward how second-hand vapour (compared to smoke) is socially received. Experiences of vaping were, however, contingent on the clinical endorsement of e-cigarettes and were inconsistent inside and outside of clinical spaces. Further consideration should be given to vaping as a harm minimisation tool in Western societies dealing with widening disparities in health. Ultimately, clozapine-treated schizophrenia patients continue to smoke or vape for reasons that speak to the desire to make ‘time’; to find connections to life rather than focusing on death.

KEYWORDS:

• Smoking
• vaping
• phenomenological health
• schizophrenia
• self-reclamation

Acknowledgements

The author wishes to sincerely thank her research participants for their involvement and interest in the ethnographic study. This research would also not have been possible without the supervisory supports of Professor Simone Dennis (Australian National University) and Dr Emilio Fernandez-Egea (University of Cambridge). The author further thanks Professor Dennis and Dr Yasmine Musharbash (University of Sydney) for their thoughtful feedback throughout the process of writing this paper.

Disclosure statement

No potential conflict of interest was reported by the author.

ORCID

Julia E. H. Brown http://orcid.org/0000-0002-8724-693X

Notes

1 Schizophrenia is a severe and ‘sublime’ category of human disorder involving profound disruptions in cognition, emotion and social functioning (Woods 2011). Clozapine is the ‘gold standard’ antipsychotic treatment for chronic schizophrenia in the UK and Australia (Dold and Leucht 2014).

2 Electronic cigarettes, hereafter referred to as ‘e-cigarettes’, were first made available in 2004. E-cigarettes are battery-powered cigarette-shaped devices that heat flavoured nicotine liquid into an aerosol, to be inhaled and exhaled by the user (Pisinger and Døssing 2014).

3 E-cigarettes are intended to be tobacco-free, although the precise chemical content of e-cigarettes is not standardised and therefore safety largely comes down to ‘subjective interpretations’ of inconclusive evidence (Pisinger and Døssing 2014).

4 Clozapine acts on the same receptors in the brain such that abrupt cessation of smoking (the most effective method for quitting) is potentially fatal (Prior and Baker 2003)

Additional information

Funding

This research is supported by an Australian Government Research Training Program (RTP) Scholarship.