A review of research on smoking cessation interventions for adults with schizophrenia spectrum disorders

Abstract

Background: Recent studies show that 75–85% of people with schizophrenia spectrum disorders in the United States smoke cigarettes, compared with 23% of the general population. Moreover, people with these illnesses on average have life expectancies 25 years lower than the general population, and smoking is a contributor.

Aims: To review intervention research and evaluate the methods and clinical findings associated with attempts to eliminate, or reduce, smoking in people with schizophrenia spectrum disorders.

Methods: PubMed and PsychInfo were searched from early 1990 through 2007 with select keywords. Thirteen treatment studies addressing smoking cessation interventions in people with schizophrenia spectrum disorders or severe mental illness were identified.

Results: Nicotine replacement therapy, psychosocial interventions, and bupropion have been studied. Overall, treatment compliance was moderate, quit rates were low, and relapse to smoking was high. Modest evidence supports the efficacy of bupropion and/or nicotine replacement combined with psychosocial interventions, and of specific psychosocial interventions combined with nicotine replacement.

Conclusion: Preliminary data show modest efficacy of nicotine replacement therapy, psychosocial interventions, and bupropion. Future studies should address motivation, effectiveness, new interventions, long-term interventions, and methods.

Keywords:

• Bupropion
• nicotine replacement therapy
• psychosocial interventions
• schizophrenia
• severe mental illness
• smoking cessation