You are in Artículos VOLUME 50 Issue 2 | Monograph "Psychobiology and substance addictions"
Nicotine use and abuse in the psychosis population: the search for optimal interventions for nicotine withdrawal is urgent
30/06/2025

Nicotine use and abuse in the psychosis population: the search for optimal interventions for nicotine withdrawal is urgent

abstract

People with psychotic disorders, such as schizophrenia, show a high prevalence of smoking (60%, compared to 20% in the general population) and severe dependence. A common hypothesis is that they smoke to self-medicate, although a more current hypothesis points to a shared genetic vulnerability between psychosis and smoking, involving dysregulation of the nicotinic receptor nAChR. Although not fully understood, it appears that nicotine may help ameliorate some negative symptoms of schizophrenia, such as lack of motivation. Temporary and short-term improvements of nicotine on several cognitive functions have also been found, which could explain its widespread use among people with psychosis. However, smoking significantly increases morbidity and mortality in patients with psychosis. Moreover, smoking can accelerate the metabolism of certain antipsychotics, which may require dosage adjustments to maintain therapeutic efficacy. Therefore, the development of specific and tailored interventions to help this population reduce and eventually cease tobacco use is crucial. We review the evidence on the efficacy of both pharmacological (bupropion, varenicline) and non-pharmacological interventions, including the most current ones such as neuromodulation techniques, for tobacco cessation in this population. It is concluded that tobacco cessation in people with psychosis may be more effective when personalized and multidisciplinary support is provided, including psychiatrists, psychologists, and other mental health professionals.

Keywords:

Psychosis, smoking, nAChR, CHRNA2, tDCS, rTMS.

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Authors

  • Marien Gadea - 1. Departamento de Psicobiología, Universitat de València. España 2. CIBERSAM (Biomedical Research Network Center. Mental Healthl). España

  • Susela Roselló - Departamento de Psicobiología, Universitat de València. España

  • Olga Sparano - Departamento de Psicobiología, Universitat de València. España

  • Julio Sanjuán - CIBERSAM (Biomedical Research Network Center. Mental Healthl). España

Financing

No funding declared

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