It is possible that nicotine exposure, by increasing the release of dopamine, causes psychosis to develop. A number of other drugs can stimulate dopamine production, including amphetamines, cocaine and cannabis
Tobacco use is the leading preventable cause of early mortality in schizophrenia, leading to a 20-year decreased life expectancy compared to the general population 2,6,7
Individuals with psychosis smoke more heavily, are more nicotine-dependent, and are less likely to quit smoking than people without a psychotic disorder 2,8,9
Cigarette smoking, by itself and in combination with other risk factors, greatly increases the risk of poor heart health (American Heart Association [AHA], 2014)
Andrasson S, Engstrm A, Allebeck P, Rydberg U
January 2026