Tobacco use is highly prevalent among patients with schizophrenia, around 3 times higher than in the general population. Furthermore, smoking is linked to higher rates of psychotic relapse, more severe symptoms, reduced quality of life, and increased mortality in schizophrenia. While the underlying mechanisms of this co-occurrence remain unclear, it is likely that shared neurobiological and genetic vulnerabilities play an important role. Understanding the neurobiological basis of smoking in schizophrenia may contribute to more effective prevention and treatment options by identifying key factors that make patients particularly vulnerable to tobacco addiction.

We investigate the neurobiological underpinnings and consequences of smoking in early psychosis using longitudinal magnetic resonance imaging (MRI) data. By analysing structural, functional, and neurochemical MRI in first-episode psychosis patients and individuals at clinical high risk, we aim to gain a comprehensive overview of the association between smoking and brain changes during this critical period. Gaining these insights can help shape more effective prevention and treatment strategies. Addressing nicotine addiction early—before full psychosis develops—may be key to preventing functional and clinical decline.