Home > Interventions for smoking cessation and reduction in individuals with schizophrenia.

Tsoi, Daniel T and Porwal, Mamta and Webster, Angela C [The Cochrane Library] . (2013) Interventions for smoking cessation and reduction in individuals with schizophrenia. London: John Wiley & Sons, Ltd. Cochrane Database of Systematic Reviews, 2 DOI: 10.1002/14651858.CD007253.pub3

URL: http://onlinelibrary.wiley.com/enhanced/doi/10.100...

Are there any effective interventions to help individuals with schizophrenia to quit or to reduce smoking?


People with schizophrenia are very often heavy smokers. It is uncertain whether treatments that have been shown to help other groups of people to quit smoking are also effective for people with schizophrenia. In this review, we analysed studies which investigated a wide variety of interventions. Our results suggested that bupropion (an antidepressant medication previously shown to be effective for smoking cessation) helps patients with schizophrenia to quit smoking. The effect was clear at the end of the treatment and it may also be maintained after six months. Patients who used bupropion in the trials did not experience any major adverse effect and their mental state was stable during the treatment.


Another medication, varenicline (a nicotine partial agonist which has been shown to be an effective intervention for smoking cessation in smokers without schizophrenia), also helps individuals with schizophrenia to quit smoking at the end of the treatment. However, this evidence is only based on two studies. We did not have sufficient direct evidence to know whether the benefit of varenicline is maintained for six months or more. In addition, there has been ongoing concern of potential psychiatric adverse events including suicidal ideas and behaviour among smokers who use varenicline. We found that two patients, among 144 who used varenicline, had either suicidal ideas or behaviour. Smokers with schizophrenia who receive money as a reward for quitting may have a higher rate of stopping smoking whilst they get payments. However, there is no evidence that they will remain abstinent after the reward stops. There was too little evidence to show whether other treatments like nicotine replacement therapy and psychosocial interventions are helpful.

Item Type:Evidence resource
Publication Type:Review
Drug Type:Tobacco
Intervention Type:AOD disorder harm reduction, Rehabilitation/Recovery
Source:The Cochrane Library
Date:February 2013
Publisher:John Wiley & Sons, Ltd
Place of Publication:London
Accession Number:HRB (Not in collection)
Subjects:G Health and disease > State of health > Mental health
J Health care, prevention and rehabilitation > Care by type of problem > Mental health care
HJ Treatment method > Substance disorder treatment method > Cessation of substance use
B Substances > Tobacco (cigarette smoking)

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