An introduction: nicotine, schizophrenia, and tobacco use

The purpose of this chapter is to review the role of nicotine in the modulation of attention, with particular application to the latent inhibition model of schizophrenia. Nicotine is the primary psychoactive chemical in tobacco. It is addictive and promotes continued tobacco use. According to the Centers for Disease Control and Prevention, the adverse health effects from cigarette smoking account for an estimated 438,000 deaths, or nearly 1 of every 5 deaths, each year in the United States – more than all deaths from human immunodeficiency virus (HIV), illegal drug use, alcohol use, motor vehicle injuries, suicides, and murders combined. The current estimate of cigarette smoking among adults in the United States is 20.8%; however, people with mental illness are much more likely to smoke, and consume a disproportionately large number of cigarettes (Goff, Sullivan, McEvoy et al., 2005; Grant, Hasin, Chou et al., 2004; Lasser, Boyd, Woolhander et al., 2000).

Schizophrenia is a cognitive disorder characterized by hallucinations and disturbances in memory, attention, and executive function. It is also characterized by an extremely high prevalence of smoking. Reliable estimates indicate that approximately 85–90% of schizophrenics smoke cigarettes (Hughes, Hatsukami, Mitchell, & Dahlgren, 1986). The co-morbidity between schizophrenia and nicotine addiction is striking and suggests that there may be common mechanisms in the pathways that lead to these diseases.