Tobacco use is significantly associated with schizophrenia. However, it is not clear if smoking is associated with illness itself, treatment, or underlying vulnerability to the disease. Smoking is recognized as a common problem in schizophrenia, based on clinical observations and epidemiological studies. Smoking has been suggested to be a marker of more severe illness, as smokers tend to have an earlier age of onset, more previous hospitalizations, and require higher doses of neuroleptic medication than nonsmokers (Goff, Henderson, @ Amico, 1992). In addition, smokers with schizophrenia tend to smoke more heavily and extract more nicotine from each cigarette than normal smokers. The reason why individuals with schizophrenia are more inclined to smoke are not well understood, and sev
eral possible explanations have been bought forth. Most of these suggest that nicotine serves as a form of self-medication, either against the side effects of the antipsychotic medications or against other deficits associated with the illness. The nicotine in the cigarettes stimulates dopamine release and has mood elevating and anxiolytic effects in normal smokers. Smoking also seems to improve cognitive performance in normal smokers. . The nicotine increases the metabolism of some typical neuroleptics; smoking may reduce some side effects of antipsychotic medications by decreasing their levels in the blood. The participants that were used for one study were Vietnam era twins. The participants were interviewed using the diagnostic interview schedule, supplemented with additional inf
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