His lung disease comes from smoking two packs a day for 35 years. Cigarettes did not cause his psychosis, of course.
Smoking is distressingly common among hospitalized psychiatric patients.
Smoking helps to allay their anxiety, and any attempt to withhold tobacco tends to make for a bad situation. As a result, although in-hospital psychiatric patients are forbidden to keep matches, smoking is not generally discouraged by the psychiatry staff. To allow smoking but not matches, many psychiatry wards install a permanent cigarette lighter at the nurse's station. I knew Mr. Switek's case would be difficult the moment I heard from Dr. Janis, his psychiatrist. This is Nancy Janis.