Prevalence of tobacco use in individuals with severe mental illnesses, São Paulo, Brazil

Abstract

OBJECTIVE: To analyze the prevalence of cigarette smoking in individuals with severe mental illnesses in a large urban centre of a middle income country. METHODS: Cross-sectional study carried out in São Paulo. The sample (N=192) comprised individuals diagnosed with severe mental illnesses who had contact with public psychiatric care services from September to November 1997 and were aged between 18 and 65 years. Prevalence of daily tobacco smoking in the 12 months previous to the interview and characteristics associated were studied. RESULTS: Out of 192 subjects with severe mental illnesses interviewed, 115 (59.9%; 95% CI: 52.6%; 66.9%) reported smoking cigarettes on a daily basis. Male gender, marital status separated or widowed, irregular use of neuroleptic drugs and history of ten or more psychiatric admissions were independently associated with cigarette smoking. CONCLUSIONS: The prevalence of cigarette smoking in the present sample was higher than that found in the general Brazilian population. Mental care services should implement non-smoking policies and mental health providers need to help patients with severe mental illness who want to quit smoking.

Cigarette smoking among psychiatric patients in Brazil

“…As in other studies, an association was found between current smoking and several sociodemographic characteristics, including being male, older age, low education level 6,11,13,14,16 , and history of homelessness 40,41 , while a negative association was found between smoking and practicing a religion 42,43 . A low level of education may be considered a marker for low access to knowledge and understanding of the harmful effects of tobacco 16 .…”

“…An association has been found between smoking and severe mental illness (schizophrenia, bipolar disorders and other psychoses), markers for clinical severity (e.g. previous hospitalization) and substance use disorders 11,12,13,14,15 . However, the nature of these associations is not always clear.…”

“…In Brazil, the few studies that exist on smoking among psychiatric patients use small samples and are limited to one service or to patients with severe mental illness 11,21,22 . Thus, the aims of the present study were to estimate the prevalence of current and past tobacco smoking and assess associated factors among each group of a national representative sample of patients with chronic mental illness in public psychiatric facilities in Brazil.…”

Cigarette Consumption and Related Factors in Schizophrenia, Schizoaffective Disorder and Delusional Disorder

“…Similarly, studies with schizophrenia patients report that cigarette use is associated to male gender (30)(31)(32)(33)(34). Smoking is also associated with male sex not only in people with schizophrenia but with other mental illnesses as well (35)(36)(37). Males have a higher smoking rate also in the general public sample (29).…”

Editorial

“…Contrariamente, tal associação parece mais evidente quando estudada em grupos populacionais específicos. Em estudos sobre o uso de tabaco, por exemplo, quando desenvolvidos com grupos de pacientes com diagnósticos definidos de alguns transtornos mentais, institucionalizados, moradores de rua ou em tratamento ambulatorial, a associação entre o consumo de SPA e a ocorrência de sofrimento psíquico mostra-se mais evidente (De Leon, Becoña, Gurpegui, Gonzalez-Pinto & Diaz, 2002;Leonard, Adler, Benhammou, Berger, Breese et al, 2001;Ratto, Menezes & Gulinelli, 2007;Usdan, Schumacher, Milby, Wallace, McNamara et al, 2001). Outro exemplo é o fato de que a ocorrência de tentativas de suicídio, em países em desenvolvimento, pode ter como fator preditivo de sua ocorrência o consumo de SPA (Nock, Hwang, Sampson, Kessler, Angermeyer et al, 2009).…”