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Smoking and Mental Illness

Every morning, I can look forward to two things: one of my cats snuggling up on my face or my older brother Derek asking someone for cigarette money.

Derek is an avid smoker, and a schizophrenic. He started smoking a few years ago, just before his diagnosis (a neighbor said it would help him with stress). For many people, especially people with mental illnesses, smoking is common. There can be a short-term feeling of relief. However, smoking can be detrimental to those with mental illness.

According to the National Institutes of Mental Health, smoking can lessen the effects of antipsychotic medication. On the other hand, other studies have shown that smoking has positive effects on attention, working memory and reflexes in people with schizophrenia. It’s possible that undiagnosed people have a chance of being medicated through cigarettes.

From what I’ve seen in my brother, smoking’s effects have led to some psychotic breakdowns. Physically, he has had a dental abscess and infection that resulted to an emergency room visit.

Derek isn’t the only mentally ill person who smokes. In fact, there are many undiagnosed people using smoking as a form of medication. Even though most states have low-income health programs, a pack of Pall Malls costs $2.90 where we live. That’s a lot cheaper than a 60-minute evaluation for $375.

Not only is there a stigma against seeking psychiatric help, people seem to have something against smoking. Smokers are like dope addicts. They have terrible breath and teeth.

The threat of lung cancer is hardly thought of when people smoke. They just need a short-term release after that long day at work, dealing with familial problems and life in general.

Self-medication is prevalent in people with ADHD, schizophrenia and bipolar disorder. The British Journal of Medicine says 56 percent of people with bipolar disorder smoke, while the Royal College of Psychiatrists states that 90 percent of schizophrenics smoke.

If you’re critical of someone with smoker breath, you might be talking about someone who is mentally ill or at an economic disadvantage.

I will say for my own self-care, I’m not interested in smoking. I tried a chocolate-flavored cigarette from a friend. I didn’t care too much for it. But I actually felt cool for a second.

Joe Eszterhas, the screenwriter of hit movies such as “Fatal Attraction” and “Basic Instinct,” featured smoking in a lot of his screenplays. Now he detests this. In many of his movies, he featured characters smoking as they looked “glamorous and cool doing it.” In his book The Devil’s Guide to Hollywood, he talks about his smoking addiction:

I smoked four packs a day and always chain-smoked when I was writing. I started smoking when I was twelve years old. In 2001, when I was fifty-seven, I was diagnosed with cancer of the throat and 80 percent of my larynx was surgically removed. I had a trache tube for months afterward and had difficulty breathing and swallowing. I finally stopped smoking and have been smoke-free now for five years … Don’t do what Dalton Trumbo and I did to ourselves; stop before it’s too late.

I’ll end this with a piece with a piece of advice for any mentally ill smokers out there: try not to be too cranky when it comes to asking for cigarette money (or just cigarettes). If you can, buy one or two individual cigarettes. At the end of the day, you want to have some kind of relief. Don’t put yourself and other people in any conflict. You got this.


National Institutes of Health. (2009). What is Schizophrenia? Retrieved October 18, 2015.

Tsoi D.T., Porwal M., Webster A.C. (2010). Efficacy and safety of bupropion for smoking cessation and reduction in schizophrenia: systematic review and meta-analysis. British Journal of Psychiatry, 196, 346.

Schizophrenia and Smoking. (2006, March). Retrieved December 10, 2015, from

Cigarette Prices Texas, What do cigarettes cost in Texas USA? (n.d.). Retrieved December 10, 2015, from

Eszterhas, J. (2002, August 8). Hollywood’s Responsibility for Smoking Deaths. Retrieved December 10, 2015, from

Eszterhas, J. (2006). The Devil’s Guide to Screenwriting (p. 156). St. Martin’s Press.

Nicotine May Help Bipolar Disorder and Schizophrenia. (2011, November 8). Retrieved December 10, 2015, from

Cigarettes photo available from Shutterstock

Smoking and Mental Illness

Brittany Green

Brittany J. Green became interested in mental health as she's been diagnosed with an anxiety disorder and her older brother has lived with schizophrenia for over a decade. She hopes to specialize in writing about mental health as a freelance writer. She features self-care tips on her blog

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APA Reference
Green, B. (2018). Smoking and Mental Illness. Psych Central. Retrieved on October 25, 2020, from
Scientifically Reviewed
Last updated: 8 Jul 2018 (Originally: 26 Dec 2015)
Last reviewed: By a member of our scientific advisory board on 8 Jul 2018
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