Tobacco Use and Impulsivity in People With Mental Illness: A Systematic Review

People with serious mental illness smoke at much higher rates than the general population: 60–88%, compared with about 11.5% of US adults. They also tend to smoke more heavily and be more dependent. Impulsivity is a known risk factor for starting and continuing to smoke, but its role in people with psychiatric disorders is poorly understood. This CME activity is based on a systematic review of 16 studies in The American Journal on Addictions. The review found a consistent link between tobacco use and impulsivity in schizophrenia, major depressive disorder and bipolar disorder. However, most studies were cross-sectional, so it isn't yet clear whether impulsivity leads to smoking or smoking affects impulsivity. The activity helps clinicians consider impulsivity when assessing risk and planning smoking cessation for patients with mental illness. It also explains what the evidence can and can't show.

Target Audience

Healthcare Professionals

Learning Objectives

  • Assess the link between impulsivity and tobacco use in people with schizophrenia, major depressive disorder and bipolar disorder.
  • Recognize the limits of the current evidence, including its reliance on cross-sectional studies and the lack of causal data.
  • Explain why people with serious mental illness smoke at higher rates, and the effect this has on their health.
  • Use these insights when assessing risk, making smoking cessation decisions, and tailoring interventions for patients with mental illness.

Activity Disclosure

No commercial support has been accepted related to the development or publication of this activity. This activity underwent peer review in line with the standards of editorial integrity and publication ethics.

Course summary

Available credit: 
  • 1.00 AMA PRA Category 1 Credit(s)™
Course opens: 
08/10/2026
Course expires: 
06/09/2029
Cost:
$0.00

Article Authors

Angela Praecht PhD, Shivahn Garvie BSc, Maryam Sorkhou PhD, James MacKillop PhD, Tony P. George MD

This activity underwent peer review in line with the standards of editorial integrity and publication ethics. Conflicts of interest have been identified and resolved in accordance with John Wiley and Sons, Inc.’s Policy on Activity Disclosure and Conflict of Interest.

 

John Wiley & Sons, Inc. is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

John Wiley and Sons, Inc. designates this journal-based CME activity for a maximum of 1.0 AMA PRA Category 1 Credit™. Physicians should only claim credit commensurate with the extent of their participation in the activity. For information on applicability and acceptance of continuing medical education credit for this activity, please consult your professional licensing board.

This activity is designed to be completed within 1 hour. To successfully earn credit, participants must complete the activity during the valid credit period, which is up to three years from initial publication. Additionally, up to 3 attempts and a score of 80% or better is needed to pass the post test and claim CC credit. [ACGME competency/CC category: Medical Knowledge].

Available Credit

  • 1.00 AMA PRA Category 1 Credit(s)™

Price

Cost:
$0.00
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