title: Health for smokers with schizophrenia - a struggle to maintain a dignified life.
abstract: OBJECTIVE
  To investigate the health and lifestyle habits of smokers with schizophrenia and describe their experience of smoking in relation to health.
  
  
  METHODS
  Semi-structured interviews with 10 smokers with schizophrenia were conducted in Sweden from May to October 2013. A hermeneutic phenomenological approach was used to describe and interpret respondents' experiences.
  
  
  RESULTS
  Good health for a person with schizophrenia was defined as accepting their mental illness, having strategies to gain control over psychotic symptoms, and engaging in activities and good relationships. Lifestyle habits were described as structures in the respondents' daily life: arising in the morning, taking a cigarette, reading the newspaper, eating breakfast and doing the things planned for the day.
  
  
  CONCLUSIONS
  The meaning of health for smokers with schizophrenia is not the same as being well or ill. Rather, health is an experience of a struggle to maintain a dignified life, including self-acceptance of the mental illness and control over the psychotic symptoms. People with schizophrenia have high willingness but low motivation to stop smoking because they fear that cigarette withdrawal will increase their psychotic symptoms. Therefore, they find it difficult to stop smoking. To succeed with health care intervention, health care providers must understand the life style habits and experiences specific to smokers with schizophrenia and the unique experience of health and life style habits that people with schizophrenia experience.
  
  
  CONCLUSIONS
  Smokers with schizophrenia experience health as a struggle to maintain a dignified life and to maintain control over their psychotic symptoms. In smoking cessation programmes, health care providers must pay attention to the fear that people with schizophrenia have of losing control over their psychotic symptoms, if they stop smoking, and support them to find activities to replace smoking. This study suggests that to provide good support in health prevention for people with schizophrenia, it is vital for the health care provider to understand their unique personal experience of health and life style habits.
authors.affiliation: a Department of Public Health and Caring Sciences , Uppsala University , Uppsala , Sweden and.|b Centre for Research and Development , Uppsala University and Region Gävleborg , Gävle , Sweden.
authors.forename: Elisabet
authors.initials: E
authors.lastname: Sundgren
authors.affiliation: a Department of Public Health and Caring Sciences , Uppsala University , Uppsala , Sweden and.
authors.forename: Johan
authors.initials: J
authors.lastname: Hallqvist
authors.affiliation: b Centre for Research and Development , Uppsala University and Region Gävleborg , Gävle , Sweden.
authors.forename: Lennart
authors.initials: L
authors.lastname: Fredriksson
mesh_terms: D000328:Adult; D004032:Diet; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D008019:Life Style; D008297:Male; D008875:Middle Aged; D009042:Motivation; D009043:Motor Activity; D036301:Qualitative Research; D012559:Schizophrenia / Q000150:complications* / Q000534:rehabilitation*; D012907:Smoking / Q000453:epidemiology*; D016540:Smoking Cessation / Q000379:methods*; D013548:Sweden
keywords: Health; hermeneutic phenomenology; lifestyle habits; schizophrenia; smokers