Research suggests that nicotine helps some people cope with schizophrenia symptoms. But alternatives, such as relaxation techniques, are available.
Living with schizophrenia can be stressful. You may experience several functionality challenges that complicate work, interpersonal relationships, and daily life.
Many people turn to smoking as a way to manage stress — even in the absence of mental health conditions.
How nicotine interacts with your brain and underlying genetic factors may contribute to the high prevalence of smoking among those living with schizophrenia.
No evidence proves smoking directly leads to schizophrenia.
Smoking and schizophrenia do appear to be interconnected, however. In a 2020 systematic review and meta-analysis, experts demonstrated that smoking (and prenatal smoke exposure) might increase the chances of developing schizophrenia.
People living with schizophrenia are also more likely than others to pick up smoking and have lower rates of smoking cessation success.
Does nicotine help treat schizophrenia?
Due to the hazards of smoking, some people may turn to alternative nicotine products to cut out cigarettes.
The verdict on the benefits of nicotine in schizophrenia is mixed.
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- In 2016, a
review of 275 studies concluded that nicotine might increase and regulate dopamine and glutamate levels for people living with schizophrenia, thereby helping to improve negative and cognitive symptoms. - In a 2018 systematic review, researchers noted that people living with schizophrenia might utilize smoking for stress relief. The same review also noted smoking withdrawal was perceived as a worsening of negative symptoms, which created a reluctance to stop smoking.
- In a 2014 study, authors noted nicotine might reduce some of the undesirable side effects of antipsychotic medications by stimulating acetylcholine receptors in the brain.
Despite these promising studies, a growing body of research cites opposing findings, according to a 2019 review of the data.
The 2019 review notes that research indicates:
- People living with schizophrenia and severe nicotine dependence often report more severe positive and negative symptoms and require higher doses of antipsychotics.
- Smoking has been independently associated with more frequent hospital visits and thought disorder deterioration.
- Relapses appear to be higher among patients who live with schizophrenia and smoke.
- Nicotine appears to improve cognitive ability at the same rate in neurotypical people as in those living with schizophrenia.
- Nicotine withdrawal may mimic symptoms of schizophrenia, creating a false sense that nicotine is treating the condition.
Symptoms of schizophrenia
Schizophrenia is a lifetime condition marked by symptoms of psychosis, such as hallucinations, delusions, or disorganized thinking.
Schizophrenia includes ‘positive’ symptoms, or symptoms that add to existing function. These include:
- hallucinations
- delusions
- disorganized thinking
- abnormal motor function
Schizophrenia also includes ‘negative’ symptoms, or those that take away from function, such as:
- flattened affect (diminished emotional expression)
- alogia (reduction in speech)
- avolition (loss of goal-driven activity)
- asociality (social withdrawal)
- anhedonia (lack of ability to experience pleasure)
Nicotine risks
Nicotine, in general, can cause potentially harmful side effects in anyone.
Premature death due to cardiovascular disease
- dietary changes
- vitamin and mineral supplementation
- amino acids
- antioxidants
- relaxation techniques
- stress management
Schizophrenia is a lifetime condition. Even with self-treatment, many people only regain functionality through guided therapy with a mental health professional and the use of prescription medications.
Not everyone who smokes is putting themselves at risk for schizophrenia. Genetics may play a significant role.
In other words, if you’re genetically predisposed to schizophrenia, you may also be genetically predisposed to smoking.
Smoking isn’t recommended for anyone, regardless of mental health.
Smoking-related illnesses affect approximately
Smoking has been linked to:
- cancer
- heart disease
- stroke
- lung disease
- diabetes
- chronic obstructive pulmonary disease (COPD)
- tuberculosis
- eye disease
- compromised immune system
- rheumatoid arthritis
What about just nicotine?
Using nicotine in alternative forms is also not recommended as a way to self-treat schizophrenia indefinitely.
Due to the potential risks associated with nicotine and the chance of increasing symptom severity in some people, experts strongly advocate replacing nicotine self-treatment with safer options.
However, nicotine used for smoking cessation may prove beneficial when not used as a long-term replacement for smoking.
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Schizophrenia is a lifelong condition, and it’s natural to want to find a way to relieve your symptoms on your own.
Smoking and nicotine use may give you a temporary boost. But they may also make symptoms worse in many people, increase the risk for schizophrenia overall, and nicotine withdrawal can be severe enough to make you feel like your schizophrenia symptoms are worsening.
Because schizophrenia is a complex condition, you may find symptoms of self-relief through other, safer avenues, such as relaxation and stress management, dietary changes, and supplements.
If you’re not experiencing adequate symptom relief, speaking with your mental health professional about medication changes, therapy options, and additional life skills development may help.