Perception of smoking risks and motivation to quit among nontreatment-seeking smokers with and without schizophrenia

Deanna L. Kelly, Heather G. Raley, Suzanne Lo, Katherine Wright, Fang Liu, Robert P. McMahon, Eric T. Moolchan, Stephanie Feldman, Charles M. Richardson, Heidi J. Wehring, Stephen J. Heishman

Research output: Contribution to journalArticlepeer-review

38 Scopus citations


Objective: We examined perceived consequences/benefits of cigarette smoking and motivation for quitting in nontreatment-seeking smokers who had schizophrenia or schizoaffective disorder (N = 100) or had no Axis I psychiatric disorder (normals, N = 100). Methods: Participants completed questionnaires and provided a breath carbon monoxide (CO) sample 10-15 minutes after smoking 1 preferred-brand cigarette. Primary assessments included the Smoking Consequences Questionnaire-Adult, the Reasons for Quitting Scale, and the Stages of Change.Results:There were no differences between the schizophrenia and control group in mean age of smoking onset (16.2 ± 5.4 vs 15.6 ± 5.5 y, P =. 44), number of cigarettes daily (17.9 ± 11.6 vs 17.0 ± 7.9, P = 0.51), or in breath CO (28.0 ± 14.5 vs 22.9 ± 8.0 ppm, P =. 61). Compared with normals, people with schizophrenia report greater stimulation/state enhancement (P <. 0001) and social facilitation (P <. 004) from smoking. People with schizophrenia had less appreciation of health risks associated with smoking than normal controls (P <. 0001) and were less motivated to quit smoking than normal controls (P =. 002), even though they were as likely to be in the preparation stage of change. Immediate reinforcement (P =. 04) and health concerns (P =. 002) were rated lower as motivators for considering quitting smoking in schizophrenia than normals. People with schizophrenia reported greater motivation to stop smoking due to social pressure/rewards than normals (P =. 047).Conclusions:This study underscores the degree to which people with schizophrenia perceive the state-enhancing effects of smoking and their lower appreciation for health risks of smoking compared with normal controls.

Original languageEnglish (US)
Pages (from-to)543-551
Number of pages9
JournalSchizophrenia bulletin
Issue number3
StatePublished - May 2012
Externally publishedYes


  • health risks
  • motivation
  • schizophrenia
  • smoking

ASJC Scopus subject areas

  • Psychiatry and Mental health


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