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CENTURY
Yale University
School of Medicine
SAC-S203
Connecticut
Mental Health Center
34 Park Street
New Haven, CT 06519

Phone:
203-974-7591

Fax:
203-974-7606

E-mail:
infocentury@yale.edu

CENTURY/TTURC Press Release

New Haven, Conn. - Schizophrenics who have severe neuropsychological problems related to their disorder have a harder time quitting smoking than regular smokers, according to a study by Yale researchers.

“Certain patients with greater deficits will have a harder time quitting,” said Dr. Kristi A. Sacco, Psy.D., Associate Research Scientist in Psychiatry, and a co-author of the study. “In order to quit, these people might need a different strategy, a more tailored approach, that would provide them with more intensive treatment.”

The article, published in the October issue of Schizophrenia Research, points out that the high rates of smoking among people with schizophrenia, along with the difficulties they have quitting, put them at a high risk for smoking-related illnesses and deaths. An examination of the relationship between the way their brain works and how it makes them more susceptible to nicotine addiction, might result in new approaches for treating nicotine addiction in this population.

People with serious mental illnesses, including schizophrenia, smoke at rates between 45 and 88 percent, much higher than the general population rates of about 23 percent. And, traditional strategies to help people quit smoking, such as the nicotine patch and bupropion, are not as effective among this population when compared to other smokers.

The study found that schizophrenics who were deficient in activities related to the prefrontal cortex – the area of the brain that regulates attention span, impulse control, organizational abilities, problem solving and critical thinking – had a particularly hard time quitting.

“Some specific features of schizophrenia include poor social functioning and cognitive deficits specific to the prefrontal cortex. These deficits partially translate into a real-life inability to recall and generalize information, two tasks that are essential for successful smoking cessation treatment,” said Dr. Sacco. “It is these inherent cognitive deficits that may make people with schizophrenia more susceptible to nicotine addiction such that the nicotine may be used as a way to help temporarily remediate some of these difficulties. Of course smoking remains one of the most significant health hazards to this population of individuals.”

Differences between quitters and non-quitters did not appear to be related to the antipsychotic treatment being received by the schizophrenics or by differences in depressive symptoms, the study says.

“I think that the most promising aspect of this work is the possibility that we could develop medications or behavioral therapies targeted to treating these prefrontal cognitive deficits in schizophrenia that might ultimately help these smokers with schizophrenia to quit smoking. This is particular significant since nicotine addiction is the most common cause of death and disability amongst these individuals” said Dr. Tony George, M.D., senior author on the study, Associate Professor of Psychiatry and director of the Program for Research in Smokers with Mental Illness at Yale.

Dr. Jed E. Rose, Ph.D., director of the Center for Nicotine and Smoking Cessation Research at Duke University Medical Center agreed.

“This is an intriguing study that has implications for why schizophrenic patients show such a high rate of smoking, and the findings suggest a treatment approach that may lead to more effective cessation strategies for this vulnerable population,” Dr. Rose said.

The citation for the article is Sara L. Dolan, Kristi A. Sacco, Angelo Termine, Aisha A. Seyal, Melissa M. Dudas, Jennifer C. Vessicchio, Bruce E. Wexler and Tony P. George . Neuropsychological deficits are associated with smoking cessation treatment failure in patients with schizophrenia. Schizophrenia Research 2004 Oct 1;70(2-3):263-75.

The study was supported in part with grants from the National Institute on Drug Abuse and the National Alliance for Research on Schizophrenia and Depression to Dr. Tony George, the study's senior author and Associate Professor of Psychiatry. Dr. George also is an investigator with the Transdisciplinary Tobacco Use Research Center at Yale (TTURC) and the Center for Nicotine and Tobacco Use Research at Yale (CENTURY).

Created with a grant from the National Cancer Institute and the National Institute on Drug Abuse, as well as grants from The Robert Wood Johnson Foundation, the Yale TTURC is part of the of the Center for Nicotine and Tobacco Use Research at Yale (CENTURY). The Yale TTURC is one of seven research centers nationwide conducting a diverse spectrum of transdisciplinary tobacco-related research.