Malignant comorbidity: schizophrenia and smoking

The prevalence of smoking among individuals with schizophrenia is higher than in those with other mental disorders and several times greater than in the general population. Moreover, the severity of tobacco dependence in patients with schizophrenia significantly exceeds that in individuals without serious psychiatric illnesses. Schizophrenia is associated with an increased susceptibility to cardiovascular and metabolic diseases, as well as a high rate of premature mortality due to both medical causes and suicide. Smoking significantly magnifies the issue, contributing to both poor physical health and increased mortality rates. The decrease in tobacco use observed in many regions of the world over recent decades has only minimally affected individuals with schizophrenia. Standard smoking reduction strategies and tobacco dependence treatments have proven ineffective or insufficiently effective for individuals with schizophrenia, which highlights the need for the development of new preventive measures and therapeutic interventions. © 2025 Elsevier B.V., All rights reserved.