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Chronic smoking tied to cognitive impairment in patients with schizophrenia

Key clinical point: Chronic smoking is associated with impairments across several cognitive domains in patients with schizophrenia.

Major finding: Compared with nonsmoking, chronic smoking was associated with a significant impairment in attention (P = .02), working memory, learning, executive function reasoning/problem solving, and speed of processing (P less than .001 for all).

Study details: A meta-analysis of 18 studies.

Disclosures: This study did not receive any funding. Amine Benyamina has given talk for Lundbeck, Mylan, Merck-Serono, and Bristol-Myers Squibb and is a member of Indivior board. Other authors declared no conflicts of interest.


“Cardiovascular diseases, cancers and respiratory diseases substantially contribute to premature mortality in people with schizophrenia, at least partially accounted for by higher rates of smoking among people with serious mental illnesses. In the general population, acute effects of nicotine can include enhanced performance in selective cognitive domains such as attention and memory, although smokers have an increased rate of cognitive decline and dementia compared to non-smokers. This meta-analysis, focused on people with schizophrenia, confirms the associations between chronic smoking and impairments in a number of key domains of cognitive functioning. Findings highlight the importance of care approaches that can successfully help people with schizophrenia quit smoking in order to improve quality of life, functional status and survival.”

Martha Sajatovic, MD

Professor of Psychiatry and of Neurology

Willard Brown Chair in Neurological Outcomes Research

Director, Neurological and Behavioral Outcomes Center, University Hospitals Cleveland Medical Center

Case Western Reserve University School of Medicine


Coustals N et al. Schizophr Res. 2020 Jun 2. doi: 10.1016/j.schres.2020.03.071.