title: Long term effects of smoking cessation in hospitalized schizophrenia patients.
abstract: The prevalence of smoking in patients with schizophrenia is higher than that in the general population and is an important medical issue. Short-term smoking cessation tends to worsen psychiatric symptoms in patients with schizophrenia but decreases sympathetic nervous system activity and improves plasma cholesterol levels in healthy people. Few studies have assessed the long-term effects of smoking cessation in patients with schizophrenia.
  
  
  
  Subjects were 70 Japanese patients with schizophrenia (38 smokers, 32 non-smokers). We compared the following clinical parameters between the two groups at baseline (before smoking cessation) and in each group separately between baseline and at three years after smoking cessation: autonomic nervous system activity, plasma cholesterol levels, body weight, drug therapy, and Global Assessment of Functioning scores. We also compared the mean changes in clinical parameters throughout this study between the groups at both time points. Autonomic nervous system activity was assessed by power spectral analysis of heart rate variability.
  
  
  
  Parasympathetic nervous system activity and the doses of antiparkinsonian drugs in smokers were significantly higher than those in non-smokers at baseline. Smoking cessation was associated with significantly decreased sympathetic nervous system activity and decreased doses of antipsychotics and antiparkinsonian drugs at three years after smoking cessation. However, there was no significant difference in the mean change in clinical factors scores, except for Global Assessment of Functioning scores, between smokers and non-smokers at three years after smoking cessation.
  
  
  
  Our results suggest that smoking reduces both autonomic nervous system activity and the effectiveness of drug therapy with antipsychotics and antiparkinsonian drugs in patients with schizophrenia, but that both factors could be ameliorated over the long term by smoking cessation. Taken together with the findings of previous studies, smoking cessation in patients with schizophrenia has many long-term positive physiological effects.
authors.affiliation: Department of Psychiatry, Yokohama City University School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama, Kanagawa, 236-0004, Japan. miyauchi-masatoshi@hotmail.co.jp.|Fujisawa Hospital, 383 Kotsuka, Fujisawa, Kanagawa, 251-8530, Japan. miyauchi-masatoshi@hotmail.co.jp.
authors.forename: Masatoshi
authors.identifier: 0000-0002-7918-2606
authors.initials: M
authors.lastname: Miyauchi
authors.affiliation: Department of Psychiatry, Yokohama City University School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama, Kanagawa, 236-0004, Japan.
authors.forename: Ikuko
authors.initials: I
authors.lastname: Kishida
authors.affiliation: Department of Psychiatry, Yokohama City University School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama, Kanagawa, 236-0004, Japan.
authors.forename: Akira
authors.initials: A
authors.lastname: Suda
authors.affiliation: Department of Psychiatry, Yokohama City University School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama, Kanagawa, 236-0004, Japan.|Clinical Laboratory Department, Yokohama City University Hospital, 3-9 Fukuura, Kanazawa-ku, Yokohama, Kanagawa, 236-0004, Japan.
authors.forename: Yohko
authors.initials: Y
authors.lastname: Shiraishi
authors.affiliation: The Division of Physical and Health Education, Setsunan University, 17-8 Ikedanakamachi, Neyagawa, Osaka, 572-8508, Japan.
authors.forename: Mami
authors.initials: M
authors.lastname: Fujibayashi
authors.affiliation: Department of Biostatistics, Yokohama City University School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama, Kanagawa, 236-0004, Japan.
authors.forename: Masataka
authors.initials: M
authors.lastname: Taguri
authors.affiliation: Fujisawa Hospital, 383 Kotsuka, Fujisawa, Kanagawa, 251-8530, Japan.
authors.forename: Chie
authors.initials: C
authors.lastname: Ishii
authors.affiliation: Fujisawa Hospital, 383 Kotsuka, Fujisawa, Kanagawa, 251-8530, Japan.
authors.forename: Norio
authors.initials: N
authors.lastname: Ishii
authors.affiliation: Faculty of General Education, Kyoto Sangyo University, Kamo-motoyama, Kita-Ku, Kyoto, 606-8555, Japan.
authors.forename: Toshio
authors.initials: T
authors.lastname: Moritani
authors.affiliation: Department of Psychiatry, Yokohama City University School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama, Kanagawa, 236-0004, Japan.
authors.forename: Yoshio
authors.initials: Y
authors.lastname: Hirayasu
mesh_terms: D000328:Adult; D000368:Aged; D014150:Antipsychotic Agents / Q000627:therapeutic use; D005260:Female; D006339:Heart Rate / Q000502:physiology; D006760:Hospitalization / Q000639:trends*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012559:Schizophrenia / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy*; D012565:Schizophrenic Psychology; D012907:Smoking / Q000453:epidemiology / Q000523:psychology* / Q000628:therapy*; D016540:Smoking Cessation / Q000379:methods / Q000523:psychology*; D016896:Treatment Outcome
chemical_list: D014150:Antipsychotic Agents
keywords: Antiparkinsonian drug; Antipsychotics; Autonomic nervous system; Body mass index; Cholesterol; Patient with schizophrenia; Smoking cessation