Research has established that there is a stronger relationship between schizophrenia patients and nicotine users. According to Kotov et al., (2010), in 20 states including the US, approximately 80 percent of the population diagnosed with schizophrenia also smoke. Research has further shown that there are there likely speculations that have been used to understand why schizophrenia’s patients smoke. Firstly, some elements of schizophrenia often cause certain individuals to engage in smoking. Secondly, smoking might be one of the etiological factors in schizophrenia, and thirdly, both environmental and genetic factors significantly cause schizophrenia and nicotine addiction (Kelly & McCreadie, 2000).
Evidently, some patients engage in smoking as one of the forms of self-medication because it might aid in the regulation of dysfunctional mesolimbic dopamine system. According to Kelly & McCreadie, (2000), nicotine has the potential to increase overall dopamine’s release particularly at the pre-frontal cortex which aids in alleviating the symptoms. Such might be the reason why the programs meant to help to quit smoking are less efficient mainly when handling schizophrenic patients. Studies have indicated that psychotic symptoms have worsened recently among individual with schizophrenic who makes any efforts to stop smoking (Kotov et al., 2010).
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It is important to note that smoking cessation intervention has been less successful due to various side effects caused by withdrawal including the changes in the cognitive and sensory deficits which apparently seem to improve while using nicotine. The other aspect is likely improvement in both the negative and positive symptoms of the disease through increasing overall level of dopamine that is deficient (Sussman & Sussman, 2011). Arguably, the withdrawal of nicotine might exacerbate schizophrenic symptoms and at the same time alter the psychiatric appearance and treatment’s response. Nicotine replacement might considerably lessen but not eliminate such symptoms. Improved drug treatment for people with schizophrenia might be suitable to make smoking cessation effective among these populations by enhancing the treatment of symptoms of schizophrenia lessening the desire for nicotine to self-medicate and lower the symptoms (Kelly & McCreadie, 2000).
Nicotine might interact with similar central pathways believed to be peculiar in schizophrenia. It is true that glumate, dopamine and serotonin play a critical role in the pathophysiology of schizophrenia. Recent studies have further implicated other types of neurotransmitters, including serotonin and glutamate in the neurobiology of psychosis and drug abuse (Sussman & Sussman, 2011). Numerous factors have contributed to the rising rates of nicotine use among patients with schizophrenia. These factors include possible positive consequence of nicotine on the neurotransmitter system engaged in schizophrenia, nicotine alleviation of psychotropic agents’ side effects, increasing symptoms of nicotine withdrawal among schizophrenia individuals in addition to social factors such as lower education level obtain and low incomes (Chowdhury et al., 2014).
According to Kotov et al., (2010), nicotine has further been shown to enhance dopaminergic tone in mesolimbic structures vital to drug reinforcement, rewards, and impacts of substances of abuse that explains tobacco seeking behavior in addition to cravings of patients with schizophrenia. Utilization of clozapine seems to be helpful with lowering smoking in schizophrenics and this is because of its effects of substituting as a nicotine agent that augment dopamine or even blocking the dopamine D4 receptor (Save, 2000). One of the factors with probable etiological importance is depression, which has to be managed mainly during the protocols of nicotine cessation. Studies have shown that interventions to quit smoking might be fruitfully adopted among the psychiatric populations.
Nicotine has the potential to increase burst activities particularly around the dopamine neurons of the ventral tegmental region. According to Kotov et al., (2010), this is often considered as firing patterns of motivational processes of the brain that helps in both cognition and learning. In different environment, Nicotine tends to play a critical role regarding improving the auditory gating which is the capability to screen out the possible intrusive environmental sound. The ability to obstruct such intrusive noise implies that an individual has significantly improved his or her attention and at the same time reduces hallucination enabling them to be productive (Chowdhury et al., 2014).
References
Chowdhury, T. G., Barbarich-Marsteller, N. C., Chan, T. E., & Aoki, C. (2014). Activity-based anorexia has differential effects on apical dendritic branching in dorsal and ventral hippocampal CA1. Brain structure and function , 219 (6), 1935-1945.
Kelly, C., & McCreadie, R. (2000). Cigarette smoking and schizophrenia. Advances in Psychiatric Treatment , 6 (5), 327-331.
Kotov, R., Guey, L. T., Bromet, E. J., & Schwartz, J. E. (2008). Smoking in schizophrenia: diagnostic specificity, symptom correlates, and illness severity. Schizophrenia bulletin , 36 (1), 173-181.
Save, Y. (2000). Diagnostic and statistical manual of mental disorders. American Psychiatric Association, 4th ed, text rev, Washington, DC: Author; Burket, RC, Schramm, LL, Therapists' attitudes about treating patients with eating disorders (1995) Southern Medical Journal , 88 , 813-818.
Sussman, S., & Sussman, A. N. (2011). Considering the definition of addiction.
