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Journal of Clinical and
Basic Psychosomatics Smoking and schizophrenia symptoms

symptoms and smoking is abundant. The previous studies smoking status and symptom severity in SCZ. Furthermore,
have found that nicotine may improve cognitive skills in the present study is a narrative review that only focused on
SCZ patients [3,23] . On the other hand, several authors have articles from PubMed and limited the searched keywords,
reported smoking as a detrimental factor. For example, excluding keywords such as “cigarette.”
nicotine may affect specific cognitive deficits, such as Future studies should aim to incorporate more
spatial working memory . In addition, smokers have balanced variables, taking into account factors such as
[3]
been found to have lower IQ scores compared to non- gender, age, AP type, AP duration, and other relevant
smokers . Similarly, smoking has not been associated sociodemographic values. Longitudinal studies are
[20]
with improved cognitive performances in treatment- necessary to explore long-term effects and changes in
resistant SCZ patients .
[17]
SCZ symptoms and smoking frequencies over time.
However, in mice models, biological differences have Furthermore, future studies should focus on investigating
been observed. For example, one study demonstrated that smoking cessation, especially in patients with SCZ. Future
nicotine can reverse hypofrontality . Moreover, another studies should investigate the reasons behind the higher
[24]
study suggested that smoking might improve attention and rates of smoking among individuals with SCZ. Specifically,
working memory . Similarly, a positive effect of smoking exploring the underlying motivations and initial desires
[25]
on divided attention was found . to smoke will help test the self-treatment hypothesis of
[23]
Furthermore, another study suggests the presence of a smoking as a means to alleviate SCZ symptoms. Moreover,
sensory gating deficit among first-episode SCZ patients, there is a need for in-depth investigations into the effects
with the deficit being less pronounced among SCZ patients of cognitive-behavioral therapy on smoking addiction and
who were current cigarette smokers . This finding aligns SCZ symptoms.
[26]
with the hypothesis of self-medication of gating deficits Acknowledgments
in SCZ through smoking, suggesting that treatments
targeting genetic dysfunctions in nicotinic-glutamatergic None.
interactions may effectively treat cognitive problems .
[27]
Funding
4.2.4. Extrapyramidal symptoms
None.
TD is a prevalent movement disorder that can occur in
patients taking both first- and second-generation AP . Conflict of interest
[34]
However, evidence suggests that nicotinic cholinergic No potential competing interest was reported by the
activity may reduce dyskinesias . Similarly, another study author.
[35]
found that SCZ patients reported a stronger motivation to
smoke than controls for reasons related to pleasure from Author contributions
smoking and the need for psychomotor stimulation .
[36]
In this context, a self-treatment hypothesis may partially Conceptualization: Kadir Uludag
explain the association between TD and smoking status. Writing – original draft: Kadir Uludag
Writing – review & editing: Min Zhao
5. Conclusion Ethics approval and consent to participate

The present study has identified an association between
smoking status and symptom severity, particularly in Not applicable.
relation to cognitive symptoms, which may support the Consent for publication
self-treatment theory of SCZ. The presence of significant
methodological heterogeneity among the reviewed studies Not applicable.
may account for the inconsistent and conflicting findings
observed in the overall analysis. Availability of data
One notable limitation is the lack of reporting on Not applicable.
smoking frequency, including whether patients were light References
or heavy smokers, in the reviewed studies. This lack of
smoking frequency data constitutes a significant limitation. 1. Strassnig M, Rosenfeld A, Harvey PD, 2018, Tardive
Some studies had missing variables, further contributing dyskinesia: Motor system impairments, cognition and
to the limitation of the present study. Furthermore, the everyday functioning. CNS Spectr, 23: 370–377.
reviewed studies do not establish a causal link between https://doi.org/10.1017/S1092852917000542

Volume 1 Issue 1 (2023) 7 https://doi.org/10.36922/jcbp.1014