Measuring Smoking Behavior in People With Schizophrenia and Bipolar Disorder

People with schizophrenia, a disabling mental disorder, smoke at rates three times higher
than those of the general population. They also tend to develop serious medical problems due
to this heavy smoking. Little is known, however, about the relationship between
schizophrenia and smoking. Smoking topography, the study of cigarette-puffing behavior, may
help to uncover important information about the smoking habits of people with schizophrenia,
and how they differ from smokers who do not have a mental illness. To develop more effective
treatment approaches for schizophrenic smokers, a better understanding of nicotine addiction
in this population is needed. This study will use hand-held smoking topography devices and
blood tests to measure smoking behavior and nicotine levels in people with schizophrenia.
This information will be compared to similar measurements in people with no mental illness
and in people with bipolar disorder, another disorder associated with high rates of heavy
smoking.

Participation in this open-label, observational study will last approximately 1 to 2 weeks,
and will consist of two to three study visits. The first visit will last about 2 hours, and
will include screening procedures, completion of baseline questionnaires, and a practice
session of smoking topography. Subjects will return on a second day (Day 2) for the
remainder of the study procedures to assess their smoking puffing behavior and nicotine
intake from usual cigarette smoking, which will occur within 1 week of the Day 1
assessments. On the afternoon prior to Day 2 subjects will have a brief appointment to
review instructions for using the topography device. They will take the topography with
them and be instructed to use it as they smoke ad-lib that evening at home. This will serve
as a second practice session for getting used to the topography device. They will also be
instructed to use the device for all cigarettes smoked upon awakening the next day at 6am
(Day 2), including the first cigarette of the day. They will go to the study site for the
first of three blood tests at 9:30 A.M, after which they will be allowed to leave the study
site to continue with their daily activities. They will use the smoking topography device
throughout the day, until 3 P.M. At this time, study staff will go to each participant's
location to collect the device. Participants will have two additional blood tests over the
course of the study to measure nicotine levels.