Current but not former cigarette smoking was associated with worse cognitive performance in stabilized schizophrenia outpatients, challenging the self-medication hypothesis.
Psychiatrists, schizophrenia patients who smoke, smoking cessation program developers, and cognitive neuroscience researchers.
Current > ex smokersCurrent but not former smoking was associated with worse cognitive performance in schizophrenia
What the researchers found
In the FACE-SZ cohort, current smokers with schizophrenia showed worse cognitive performance than non-smokers and former smokers, contradicting the common assumption that nicotine provides cognitive benefits in schizophrenia.
Why it matters
Tobacco use is extremely common in schizophrenia, often rationalized as self-medication for cognitive deficits. Finding that smoking is actually associated with worse cognition challenges this narrative and supports cessation efforts.
The numbers in context
Results from the FACE-SZ cohort of stabilized schizophrenia outpatients, examining tobacco use status and comprehensive cognitive assessment.
How the study worked
Cross-sectional cohort study using the FACE-SZ database to compare cognitive performance across smoking status groups in stabilized schizophrenia patients.
Who was studied
Stabilized schizophrenia outpatients in the FACE-SZ cohort classified by current, former, or never smoking status.
What this study cannot tell us
Cross-sectional design cannot determine if smoking causes cognitive decline or if lower cognitive function predisposes to smoking; cohort effects possible; medication differences between groups.
How to read the evidence
Large cohort study with comprehensive cognitive assessment; cross-sectional design limits causal inference.
When this study was published
Recent analysis from a well-characterized French schizophrenia cohort.
The bigger picture
This study challenges a deeply held assumption in psychiatry and provides evidence supporting tobacco cessation programs for people with schizophrenia, who have among the highest smoking rates of any population.
Replication
Challenges prior short-term studies showing nicotine cognitive benefits; larger cohort with comprehensive assessment adds weight.
Funding
Not specified
Conflicts of interest
Not specified
Questions still open
- Does smoking cessation improve cognition in schizophrenia?
- Is the cognitive deficit from nicotine or other tobacco components?
- How does cannabis co-use interact with these findings?
Read the original research
Current (but not ex) cigarette smoking is associated with worse cognitive performances in schizophrenia: results from the FACE-SZ cohort.
Psychological medicine, 53(11), 5279-5290
Citation
Mallet, Jasmina; Godin, Ophélia; Dansou, Yecodji; Mazer, Nicolas; Scognamiglio, Claire; Berna, Fabrice; Boyer, Laurent; Capdevielle, Delphine; Chéreau, Isabelle; D'Amato, Thierry; Dubreucq, Julien; Fond, Guillaume; Leigner, Sylvain; Llorca, Pierre-Michel; Misdrahi, David; Passerieux, Christine; Rey, Romain; Pignon, Baptiste; Urbach, Mathieu; Schorr, Benoit; Schürhoff, Franck; Yann, Le Strat; Dubertret, Caroline. (2023). Current (but not ex) cigarette smoking is associated with worse cognitive performances in schizophrenia: results from the FACE-SZ cohort.. Psychological medicine, 53(11), 5279-5290. https://doi.org/10.1017/S0033291722002574