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Cigarette Smoking And Psychosis: Naturalistic Follow up 4 Years After an Intervention Trial

Objective: Cigarette smoking is very common among people with a psychotic disorder and is often not addressed by clinicians. Additionally, few studies have evaluated smoking interventions among this group. The present study reports findings from a naturalistic follow up 4 years after a smoking intervention trial. Method: Longer-term smoking, symptomatology and functioning were examined among 247 participants (recruited in Sydney and Newcastle, Australia) who initially attended a 1 year follow up of an eight-session individually administered trial for regular smokers with a psychotic disorder. Variables profiled included continuous and point prevalence abstinence rates, smoking reduction status (no reduction, <50%, ≥50%, or abstinence) and changes in anxiety, depression and current functioning. Results: Two-thirds of those who completed the 1 year assessment were followed up at 4 years (164/247, 66.4%), of whom 79.2% reported maintenance or improvement in their smoking reduction status relative to 1 year. Abstinence at 1 year was significantly associated with 4 year point prevalence abstinence. Lengthy periods of abstinence were also evident among those reporting 4 year point prevalence abstinence or at least a 50% reduction. No baseline or intervention status variables predicted smoking status at 4 years. Symptomatology and functioning also improved between baseline and 4 years. Conclusions: Smokers with a psychotic disorder are capable of long-term change. It is recommended that clinicians address and monitor smoking during treatment of people with psychosis, emphasizing potential lifestyle and harm reduction benefits, with a view to eventual smoking cessation.