Prevalence and determinants of tobacco use amongst South African adults with mental illness in the Eastern Cape

Abstract

Background: Given the physical and mental health consequences of tobacco use amongst individuals with mental illness, it was imperative to assess the burden of tobacco use in this population.Aim: This study examined the patterns and factors associated with tobacco use in individuals attending the outpatient unit.Setting: Cecilia Makiwane Hospital Mental Health Department in Eastern Cape province, South Africa.Methods: Lifetime (ever use) use and current use of any tobacco products were examined in a cross-sectional study of 390 individuals between March and June 2020. A logistic regression was fitted to determine the correlates of lifetime and current use of any tobacco products.Results: The rates of ever use and current use of tobacco products were 59.4% and 44.6%, respectively. Of the participants interviewed, lifetime tobacco use was more prevalent amongst individuals with schizophrenia (67.9%) and cannabis-induced disorders (97.3%) and lower in those with major depressive disorders (36.1%) and bipolar and related disorders (43.5%). Men were six times more likely to have ever used or currently use tobacco products in comparison to women. Also, those who had a salaried job or owned a business were over three times more likely to have ever used or currently use tobacco products compared with those receiving government social grants.Conclusions: The prevalence of tobacco use in this study was significantly higher than the general population in the Eastern Cape. Therefore, smoking prevention and cessation interventions targeted at the general population should target this often neglected sub-population in the region.

An Exploration of Smoking Patterns Among People with Serious Mental Illness Attending an Outpatient Clinic in Qatar

“…This finding suggests that the smoking rate among SMI individuals in Qatar may be between 2-3 times higher than the rates reported for the general population (21.5%), 18 and is in line with the majority of studies both, worldwide and those within the Middle East region, comparing the smoking rates between SMI samples and those in the general population. 7,16,17,[24][25][26][27][28][29] We also found that smoking was strongly associated with the male gender, which is broadly consistent with the findings in smoking prevalence studies, both in the general population and in people with SMI. 8,16,25,26,[30][31][32] Similarly, as with other studies in the Middle Eastern region, [27][28][29] we found more significant differences in smoking rates in males versus females.…”

“…These differences were broadly consistent with prevalence rates derived from other studies worldwide, which reported the largest smoking rates among those with psychotic disorders. 8,24,[26][27][28][29]37 This diagnostic group in our sample also showed the highest rate of current smokers (51.7%) compared to those diagnosed with mood disorders (32.7% for MDD and 26.2% for bipolar disorder). The most widely accepted hypothesis for the higher prevalence of current smoking among people with psychotic disorders is self-medication; that is, because nicotine stimulates dopamine release in the nucleus accumbens, activating reward pathways, smoking may ameliorate negative symptoms in schizophrenia, and possibly also overcome dopamine blockade by antipsychotic medications.…”

“…This finding suggests that the smoking rate among SMI individuals in Qatar may be between 2–3 times higher than the rates reported for the general population (21.5%), 18 and is in line with the majority of studies both, worldwide and those within the Middle East region, comparing the smoking rates between SMI samples and those in the general population. 7 , 16 , 17 , 24–29 …”

Smoking cessation among people with mental illness: A South African perspective

“…In one of the few studies conducted in South Africa among PWMI by Tindimwebwa et al in 2020 at the Cecilia Makiwane Hospital in Eastern Cape, 59.4% of 390 outpatient participants reported using tobacco at some point in their lives. 8 The lifetime prevalence of tobacco use differed in various disorders: cannabis-induced disorders (97.3%), schizophrenia (67.9%), bipolar and related disorders (43.5%) and major depressive disorders (36.1%). 8 These rates are even higher among psychiatric inpatients.…”

“… 8 The lifetime prevalence of tobacco use differed in various disorders: cannabis-induced disorders (97.3%), schizophrenia (67.9%), bipolar and related disorders (43.5%) and major depressive disorders (36.1%). 8 These rates are even higher among psychiatric inpatients. In a study conducted among 116 inpatients at Stikland Hospital in the Western Cape, Du Plooy et al 9 found that 91.4% were current smokers.…”