[Why stopping smoking is difficult in patients suffering from schizophrenia? How better to take care of them?]

Smoking is much higher among patients suffering from schizophrenia compared to the general population. These patients inhale the smoke more deeply and extract a significant amount of nicotine from the cigarette. They are highly addicted to tobacco and their attempts to stop smoking are more frequently marked by failures. The continuation of consumption exposes them particularly to the risk of diseases and mortality related to smoking. Various hypotheses are advanced to explain the association between schizophrenia and tobacco smoking. Tobacco smoke and/or nicotine appear to compensate for certain cognitive deficits due to the disease or to correct adverse events of anti-psychotics. Furthermore, genetic factors, personality traits and socio-cultural factors appear to be jointly implicated in mental illness and smoking. Smoking cessation, which does not aggravate schizophrenia, combines psycho-social approaches and medication treatments; it can be helped by the use of the electronic cigarette and the practice of physical exercise. Professionals must ensure long-term personalized follow-up.