MedWire News: Challenging positive expectations and providing information on the negative consequences of smoking increase the motivation of schizophrenia and schizoaffective patients to quit smoking, conclude US investigators.
It has been shown in a number of different populations that smoking expectations, in terms of both positive expectations of smoking and the negative health consequences, are associated with intention to quit and predict smoking cessation success. However, while smoking has been widely studied in schizophrenia, the links between smoking expectancies and understanding and intention to quit have not been investigated.
Jennifer Tidey, from Brown University in Providence, Rhode Island, and colleagues studied 46 smokers with schizophrenia, 35 smokers with schizoaffective disorder, and 71 smokers without psychiatric illness, all of whom were heavy smokers.
Positive and negative smoking expectancies were examined using the Smoking Effects Questionnaire (SEQ), while intention to quit was assessed using the State of Change algorithm. Precontemplation was defined as not intending to quit within 6 months, contemplation as intending to quit within 6 months but either not intending to quit within 30 days or not having made a 24-hour quit attempt in the past year, and preparation as intending to quit within 30 days and having made a 24-hour quit attempt in the past year.
There was no significant difference in the number of cigarettes smoked per day among the groups, but both patient groups had significantly higher breath carbon monoxide levels than controls and schizophrenia patients had significantly higher salivary cotinine levels than those in the other two groups.
All three groups rated a reduction in negative effect of smoking as the most important factor in smoking expectancy and intention to quit smoking was systematically related to concerns about the health effects and social consequences of smoking.
Schizoaffective disorder patients were more likely than schizophrenia patients and controls to be concerned about social expectancies and with the immediate negative physical effects of smoking.
Intention to quit had a significant main effect on all three negative expectancy scales of the SEQ – the Future Health Concerns, Negative Physical Effects, and Negative Psychosocial Effects scales. Schizoaffective disorder patients who were in the preconception phase on their intention to quit placed significantly higher importance on the Positive Social Effects scale of the SEQ, a pattern that was not seen for schizophrenia patients and controls.
The team concludes in the journal Schizophrenia Research: "The results of this study support the importance of focusing on the expected pros and cons of smoking in motivation interviewing and other cognitive behavioral interventions for tobacco dependence in people with schizophrenia and schizoaffective disorder."
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