Smoking cue reactivity and smoking motives in patients with early phase psychotic disorder

Rates of tobacco smoking in individuals with psychosis are high and are unfortunately accompanied by low rates of successful smoking cessation. Exposure to smoking-related cues is shown to reliably enhance cigarette cravings in dependent people who smoke recruited from the general population. Recent data suggests that smoking-related cues do not affect people who smoke diagnosed with established schizophrenia to the same degree as non-psychotic populations. However, less is known about how individuals in the early phase of psychotic illness react to these cues. In addition, it is unknown whether the smoking motives of individuals with early phase psychosis (EPP) differ from those of non-psychotic individuals who smoke (NPS).

The present study compared cue-elicited cigarette cravings of EPP (n = 21, mean(sd) age27.6(7.8) years) to NPS (n = 40) in response to a smoking cue-reactivity paradigm and additionally, compared general self-reported motives for smoking across these groups.

Similar to those with established psychosis, EPP individuals were less sensitive to the cue-reactivity paradigm, suggesting that individuals in early phase of illness may not be affected by tobacco cues to the same degree as NPS. Further, comparison of smoking motives suggests no differences between the reasons for smoking reported by individuals with EPP and NPS.

These findings have implications for future studies aimed at identifying the source of the wide discrepancy in rates of tobacco smoking and smoking cessation across these two populations, and for the development of effective smoking cessation interventions for people who smoke with EPP.