Previously the fact that people with psychotic mental illnesses are more likely to smoke has been put down to non-causal factors, such as obtaining relief from distress or self-medication. Dr James MacCabe, a member of the team from King’s College London, said: ‘While it is always hard to determine the direction of causality, our findings indicate that smoking should be taken seriously as a possible risk factor for developing psychosis, and not dismissed simply as a consequence of the illness.”