Smoking and Schizophrenia

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In the late 1980s, one of the most life changing events that happened to me was how my parents, community business leaders in a small town in Texas, went from having a wonderful upper middle class life to virtually poverty.

That basically meant that my family and I would move from the rodeo loving, barn dancing state of Texas to the stiff upper lipped land of the United Kingdom, moreover, England.

In the Texan days, my father was a habitual smoker. Always smelled of tobacco and our house back then was almost always covered in tobacco dust… well, to grant respect to my mum, she cleaned that house daily, religiously.

When we moved to England, having barely two pence to rub together, my father quit smoking and that was when I picked up the habit myself.

A twelve year old boy, just starting the journey into adulthood. And I thought a great way to begin this would be to smoke.

My dad smoked, his mum smoked, his dad smoked and I expect his vicar dad smoked too. As usual, I can only trace my family’s habit of smoking back to Vivienne, my dad’s grandfather and I can only assume that he smoked. He died a few years before I was born.

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It should be noted that this article will not be some long, boring story about the genealogy of the generations of smokers in my family, but really how me, being schizophrenic, love smoking.

Ultimately, how people with serious mental heath illnesses tend to smoke more than the general population.

Ten years ago, in around 2015, I spoke with the chair of one of London’s best metal health trusts, South London and Maudsley Mental Health NHS service.

He pointed out a little known fact that 20% of the population smoked then and of that 80% of them, were service users.

A service user is normally someone who might be of ill repute (to the general middle classes) who accesses various services like drugs services, unemployment services, mental health counselling or whatever.

A service user, or ‘client’, which is the more politically correct term today would be someone who needs support to come off drugs, alcohol, gambling, sex working and so on. People who access services to manage their affliction.

I see what the system calls services users every day when I walk around in my community in Lewisham. Maybe a skinny guy who looks dishevelled and might be talking to himself, carrying a black plastic carrier bag, full of ultra processed food and 4 cans of high percentage Skoll beer. Kind of like the guy who you wouldn’t really want to have a conversation with or take back to your mum’s home for a cup of tea and cake.

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Having said that, I guess in the same breath, Amy Winehouse might have been a service user too in her darkest days.

What I am trying to say is how smoking and mental ill health really do go hand in hand (See Amy again).

I smoked through my boarding school days, I smoked through my university days and I smoked through my darkest days.

Much of those smoking days were filled with smoking weed too, but that is also a different subject altogether.

It has been said that smoking is bad for you, but in the same breath, my doctor said that regularly taking medication is pretty much bad for you too. It is all about the balance of the equation as to which is more toxic, the illness or the medication (see cancer treatments).

I am now 50 years old, have been smoking for about 2/3 of my life and have had schizophrenia for just over half my life.

During my university days, I used to smoke weed with my peers. That was the most social times of my life. Sit around, play Mario Cart, smoke spliffs and bongs and discuss the nature of life overall.

On reflection, if I reflected on the topics of conversations we had during those times, I would have to cringe quite a lot…

During my recovery from psychosis, in London, my best friends and I would sit in a small room with Baggins, a cute little lapdog and smoke spliff after spliff — and of course dress Baggins up in his favourite tutu for a good laugh!

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Over the course of my weed smoking career, my professional career certainly did not take off.

Every job I would get would result in my forced resignation, which would lead to a worse job every time to the point of the chain leading to, but not reaching, the point of being a bin collector.

I begged my psychiatrist to help me quit weed and he did.

I worked with a dual diagnosis practitioner and she persuaded me that life on the other side of weed addiction was a lot better and indeed, it really was. Is, even.

As a service user, I opened a social club for my peers and me. It was great. I even encouraged those of us who smoked to not feel guilty. To have no remorse.

And that is kind of what I am trying to say, that smoking for us with mental health problems really do go hand in hand.

If you go to a mental health hospital, almost inevitably, there will be people standing outside, even in the rain and snow, puffing on their rollies or cigarettes.

I am fully aware of the risks of smoking. That half of the population will get cancer and a good percentage of that will probably die as a result.

So far, I have had at least three or four people from my life who died of lung cancer or throat cancer who I knew very well.

Why do I keep on smoking then?

Every time I quit smoking, I would put on dozens of pounds of weight and have to buy new clothes and be scorned at by the general population for being fat. So there is the weight thing that keeps me hooked.

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The other thing is how, when I quit, my anxiety would go from hello to fucking hell fuck hell hello fuck… so that isn’t great either.

I’ve tried patches, inhalers and even vapes and none of those helped… only cost a small fortune and then the food bill would be very high to.

Life is great now. I’m 50. I’m in that age bracket where cancer will probably get me sooner or later. My wonderful friend, Gary was in his 50s when he died of throat cancer… a very ugly, painful death. My old friend James the artist died in his early 60s of lung cancer… and it is well known that schizophrenics die ten years before the general population, so why won’t I just quit and enjoy life a bit longer… I don’t know.

What I do know though, is that when I finish this draft, I will make myself a double espresso and have a glass of water with it and review my work over a rollie.

Does that make me an undisciplined idiot? I think so. But I just need that cigarette with a coffee like the rain needs clouds.

Can I quit? Maybe. Do I want to quit? Not right now. Should I quit? Definitely.

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