Smoking and dependence on nicotine are very common in people with mental disorders. Although smokers comprise about 30 percent of the United States population, they make up a much larger percentage of people with emotional problems. For instance, between 75 and 90 percent of people with schizophrenia are addicted to nicotine, according the National Institute of Mental Health (NIMH).

In addition, smoking, and withdrawal from quitting smoking, can trigger certain disorders (e.g., major depression, dysthymia) in people who are predisposed to them.

Patients with mental health conditions frequently use cigarette smoking as a means of self-medication. Nicotine has many affects on both the mind and the body, several of which (e.g., reduced anxiety, improved concentration) may seem beneficial in the short run. However, the dangers of nicotine far outweigh the perceived advantages. Smoking increases a patient’s risk for many health problems (e.g., cancers, heart and lung diseases, peptic ulcers) and increases the risk of problems (e.g., low birth weight) in infants whose mothers smoked during pregnancy. Secondhand smoke is also dangerous to those around people who smoke.

Nicotine is a highly addictive substance with immediate withdrawal symptoms. Of all the nicotine products available, cigarettes cause the most rapid onset of nicotine effects. This tends to lead to heavier use and makes smoking more difficult to quit. Furthermore, when patients attempt to quit smoking, symptoms of withdrawal are generally more severe in patients who smoke cigarettes.

Withdrawal generally begins within a few hours of the patient’s last cigarette and symptoms become most intense after the first day. They tend to improve after three to four weeks. Symptoms of nicotine withdrawal include cravings, increased appetite, weight gain, depressed mood, irritability, frustration or anger, anxiety, insomnia and coughing.