Chewing Beedis: A Case of Cross-Tobacco use in a Patient with Schizophrenia

While tobacco use occurs in many forms all over the world, there is little information on cross-tobacco use. Authors report an unusual case of tobacco use in the form of chewing beedies which are normally smoked (cross-tobacco use). A 22-year-old single female, diagnosed with schizophrenia for the last 6 years, started chewing beedies from the age of 15 years and was using it in a dependent pattern since 7 years. After 3 years of treatment for her schizophrenia, patient's family pressured her to seek tobacco cessation treatment. Initial treatment with nicotine gum replacement and behavioral counseling did not prove useful. Subsequently she was treated with bupropion 300 mg/day and able to successfully abstain. Cross-tobacco use is relatively rare, and merits further study, especially in the mentally ill population.