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Helping people with schizophrenia to quit smoking
  1. Toshi A Furukawa
  1. Departments of Health Promotion and Human Behavior and of Clinical Epidemiology, Kyoto University Graduate School of Medicine/School of Public Health, Kyoto, Japan;

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Clinical case


A 38-year-old man.

Present illness

The patient developed schizophrenia in his mid-20s when he was working as a shop assistant in a busy supermarket. He was increasingly unable to concentrate, felt that he was laughed at by his colleagues and customers, and started seeing a psychiatrist after he heard voices and felt he was no longer able to control his body by his will. He has had two brief hospitalisations in the interim, worked in several temporary jobs but not been able to keep a steady job over a year. For the past 2 years, he has been attending the day care centre 4 days a week.

Present status

He has been a heavy smoker since his 20s, smoking at least one packet a day. The consumption usually increased when he did not have a job and has remained at two packets a day for the past 2 years. Recently, there was some discussion around the harms of cigarette smoking at the day care centre and he wonders if there is any medication that may help him in stopping cigarette smoking. He says he has tried several times on his own in vain. His present mental status mainly consists of negative symptoms (blunted affect, social withdrawal and anhedonia) and some residual positive symptoms (vague and distant auditory hallucinations). He does not suffer from substance-related disorders other than tobacco use disorder.

Formulate your clinical question

  • Patients: Patients with schizophrenia who smoke

  • Intervention: Pharmacological intervention

  • Comparison: Placebo

  • Outcomes: Continued abstinence from …

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