Smoking, smoking withdrawal and schizophrenia: Case reports and a review of the literature

Our efforts to study and understand the complex clinical, behavioral, neurochemical and neuroanatomical manifestations of the schizophrenias are plagued by the heterogeneity of findings, and lack of ability to define subtypes within the syndrome. Theoretically, a behavior associated with schizophrenia among a majority of those affected might provide more broadly applicable information about the illness. Cigarette smoking represents such a behavior. Herein we present an overview of evidence linking cigarette smoking and schizophrenia, and describe three cases suggesting that nicotine withdrawal leads to an exacerbation of schizophrenic symptoms.