Perception of smoking risks and motivation to quit among nontreatment-seeking smokers with and without schizophrenia.
OBJECTIVE
We examined perceived consequences/benefits of cigarette smoking and motivation for quitting in nontreatment-seeking smokers who had schizophrenia or schizoaffective disorder (N = 100) or had no Axis I psychiatric disorder (normals, N = 100).


METHODS
Participants completed questionnaires and provided a breath carbon monoxide (CO) sample 10-15 minutes after smoking 1 preferred-brand cigarette. Primary assessments included the Smoking Consequences Questionnaire-Adult, the Reasons for Quitting Scale, and the Stages of Change.


RESULTS
There were no differences between the schizophrenia and control group in mean age of smoking onset (16.2 ± 5.4 vs 15.6 ± 5.5 y, P = .44), number of cigarettes daily (17.9 ± 11.6 vs 17.0 ± 7.9, P = 0.51), or in breath CO (28.0 ± 14.5 vs 22.9 ± 8.0 ppm, P = .61). Compared with normals, people with schizophrenia report greater stimulation/state enhancement (P < .0001) and social facilitation (P < .004) from smoking. People with schizophrenia had less appreciation of health risks associated with smoking than normal controls (P < .0001) and were less motivated to quit smoking than normal controls (P = .002), even though they were as likely to be in the preparation stage of change. Immediate reinforcement (P = .04) and health concerns (P = .002) were rated lower as motivators for considering quitting smoking in schizophrenia than normals. People with schizophrenia reported greater motivation to stop smoking due to social pressure/rewards than normals (P = .047).


CONCLUSIONS
This study underscores the degree to which people with schizophrenia perceive the state-enhancing effects of smoking and their lower appreciation for health risks of smoking compared with normal controls.
Maryland Psychiatric Research Center, University of Maryland, Baltimore School of Medicine, Box 21247, Baltimore, MD 21228, USA. dkelly@mprc.umaryland.edu
Deanna L
DL
Kelly
Heather G
HG
Raley
Suzanne
S
Lo
Katherine
K
Wright
Fang
F
Liu
Robert P
RP
McMahon
Eric T
ET
Moolchan
Stephanie
S
Feldman
Charles M
CM
Richardson
Heidi J
HJ
Wehring
Stephen J
SJ
Heishman
D000328:Adult; D015897:Comorbidity; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D008875:Middle Aged; D009042:Motivation / Q000502:physiology*; D012307:Risk Factors; D012559:Schizophrenia / Q000453:epidemiology / Q000503:physiopathology*; D012565:Schizophrenic Psychology; D012907:Smoking / Q000453:epidemiology / Q000523:psychology*; D016540:Smoking Cessation / Q000523:psychology*; D011795:Surveys and Questionnaires