Prevalence and correlates of smoking and nicotine dependence: results of a nationwide cross-sectional survey among Singapore residents

Abstract

BackgroundSince the Singapore Mental Health Study in 2010 which reported a 16.0% prevalence rate for current smokers and 4.5% for nicotine dependence, new anti-smoking strategies have been implemented. The aim of this study was to compare smoking trends from the 2010 study with the second Singapore Mental Health Study in 2016 (SMHS 2016).MethodsA survey of 6126 individuals aged 18 years and above randomly selected among Singapore residents was conducted using the same methodology as the 2010 study. The measures used in this analysis were sociodemographic questions, the Composite International Diagnostic Interview which assessed for psychiatric disorders, the Fagerstrom Test for Nicotine Dependence and a list of chronic physical conditions that were prevalent in Singapore. Logistic regression analyses were used to test for associations between smoking/nicotine-dependence and other measures.ResultsIn the SMHS 2016, 16.1% were current smokers and 3.3% were nicotine-dependent. As compared with non-smokers, current smokers were more likely to be younger, male gender, of ethnic minority and had lower/vocational education level. Younger age, male gender, lower/vocational education and psychiatric disorders (major depression, bipolar disorder and alcohol use disorders) predicted nicotine dependence. No associations were found between nicotine dependence and any of the chronic conditions.ConclusionThe prevalence of current smokers in the population has plateaued while that of nicotine dependence has decreased from 2010. However, the study did not investigate the use of e-cigarettes. Inequalities in smoking and nicotine dependence continue to pervade the population particularly among those of ethnic minority, lower/vocational education and the mentally ill.

Smoking and Mental Illness: Prevalence, Patterns and Correlates of Smoking and Smoking Cessation among Psychiatric Patients

“…Singapore imposes comparatively higher tobacco taxes compared to other ASEAN countries, which was adjusted based on the national prevalence of smoking over the years. Nonetheless, the prevalence of smoking remains unchanged in the population, with no sign of reduction over the years [11,12]. In view of the endorsement of both smokers and past smokers, increasing the cost of cigarettes is one of the strong deterrents of smoking.…”

“…FTND is a 6-item scale scored from 0 to 3. The total score is calculated by totalling the responses for the 6 items and a score of 0 to 4 is classified as low dependence, 5 to 7 as moderate and above 8 is scored as high dependence [12]. A cut-off score of 5 and above was set for nicotine dependence.…”

“…In 2012, a national level epidemiological study among individuals aged 18 and above showed that 16% of the resident population were current smokers [11] with 4.5% dependent on nicotine. A recent national survey using the same methodology showed no change in the prevalence of smoking in Singapore (16.1%) over the years [12], despite the ongoing awareness programmes. In addition, the prevalence of nicotine dependence (ND) decreased from 4.5% to 3.3% [12].…”

“…A recent national survey using the same methodology showed no change in the prevalence of smoking in Singapore (16.1%) over the years [12], despite the ongoing awareness programmes. In addition, the prevalence of nicotine dependence (ND) decreased from 4.5% to 3.3% [12]. The National Registry of Diseases in Singapore [13] registered higher rates of smoking among those with cardiovascular diseases (43.2%), stroke (36.4%), and cancer.…”

“…Previous local studies have looked at the national population sample [11,12] and it is not clear how different the population with mental illness is as compared to the general public in terms of prevalence rates and smoking characteristics. Hence it is important to understand the smoking patterns, severity, and motivators/deterrents for cessation in the psychiatric population.…”