An Epidemiological Analysis of Smoking and Smoking Cessation among Persons Undergoing Inpatient Treatment for Psychiatric Illness

Abstract

Background: Tobacco use increases the odds of suffering and dying prematurely from a host of chronic disease, including heart disease, stroke, cancer, lung diseases, and mental illness. There is limited published data especially from Canada on the prevalence, etiology, consumption patterns and treatment of tobacco use among persons with mental illness.

Objectives: First, understand the social epidemiology and describe the characteristics of a typical smoker with mental illness. Second, understand the likelihood of receiving smoking cessation interventions in mental health institutions of Ontario.

Methods: Secondary analysis of the data obtained using the Ontario Mental Health Reporting System (OMHRS). Census level data collected from all the individuals admitted to mental health institutions in Ontario during the period of October 2005 and September 2006. Cross tabs were used to analyze the social epidemiology of smokers. Odds ratios were calculated for the likelihood of the psychiatric diagnosis and receiving smoking cessation intervention.

Results: Forty-seven percent of the individuals admitted in mental health beds during the study duration were smokers. The mean age of smokers was lower as compared to non-smokers. Individuals with the diagnosis of substance use disorder were the most likely to be smokers as compared to the reference group. Smokers scoring higher on CAGE score or having a diagnosis of substance use disorder and had more than 5 drinks of alcohol in the last 14 days are more likely to receive the intervention as compared to other smokers.

Conclusion: The results of this study suggest that significantly huge populations of individuals in mental health institutions are smokers. The smoking prevalence is higher in males and these males are also more likely to have a diagnosis of substance-related disorder. There is a lack of smoking cessation interventions in mental health facilities.