Smoking Reduction May Decrease Suicidality in Patients With Psychosis

People with severe mental illness are at heightened risk for both substance misuse and suicide, and several lines of research have shown a connection between the two. A study published in Psychiatry Research suggests that patients with psychosis who smoke less may also be less likely to experience suicidal ideation or behaviors.

These findings came from a study of 235 smokers aged 18 or over with a psychotic disorder who participated in a healthy lifestyle intervention trial in Newcastle, Sydney, and Melbourne, Australia. The study participants smoked at least 15 cigarettes a day at the start of the trial, were diagnosed with a schizophrenia spectrum or bipolar disorder as confirmed by the Mini International Neuropsychiatric Interview, and were taking antipsychotic medication as prescribed for a period of at least two months. Suicidality was assessed using the Brief Psychiatric Rating Scale (BPRS) at the start of the trial and at follow up 15 weeks and 12 months later.

While there was no association between reduced smoking and suicidality at 15 weeks, significant association was seen at 12 months. This association was reduced, but not eliminated, when depression was factored in, with the authors estimating that depression accounted for around 30% of the connection between smoking and suicidality.

“In addition to physical health impacts, the results of the present study provide a further important reason why clinicians should address smoking in this population,” the authors wrote.

For more information, see the Psychiatric News article “Giving Patients With Serious Mental Illness Mobile Boost to Quit Smoking.”

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