Abstract

Smoking is one of the leading causes of mortality and morbidity in both developing and developed nations, accounting for 8 million deaths globally with more than 7 million deaths directly related to tobacco use. Tobacco consumption increases the risk of lung diseases, stroke, cardiovascular diseases and cancer. There is a need to understand the prevalence, and factors associated with smoking in treatment-seeking psychiatric patients.
Aim and Objective of the study: To estimate the prevalence of smoking among psychiatric subjects and to study the factors associated with smoking and to find out the factors that encourage smoking cessation.
Materials and Methods: A modified version of the Global Adult Tobacco Survey (GATS) was used to capture data thatincluded sociodemographic information (age, gender, ethnicity, education, housing, income, etc.), and questions regarding their smoking status. A descriptive analysis of the data was done. The clinical diagnosis of the participant was captured as indicated in the electronic medical records which follows the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) criteria. Participants were also asked if their smoking started before their psychiatric condition was diagnosed and if they have suffered from any of the smoking-related diseases.
Results and Discussion: Out of the total  a total of 400 subjects screened in our study, 380 participated in the study after informed consent. We evaluated the prevalence of smoking among the study participants and found that the prevalence of smoking was 48% (182), past-smokers 13% and non-smokers 39% respectively. Majority of the smokers were males. Family history of smoking was reported in 79% of the smokers and 83.2% in past smokers. 56% of the current smokers (n=102) had nicotine dependence and 37.5% of the past smokers (n=18) had nicotine dependence. There was no statistically significant difference (p<0.05) between current smokers and past smokers w.r.t nicotine dependence.
Conclusion: The factors associated with smoking included gender, employment, education and diagnosis of schizophrenia spectrum, depressive disorder and other psychotic disorders. Males were more likely to smoke as compared to females, male gender was statistically significantly associated with smoking. Subjects with primary education as the highest qualification had a higher likelihood of smoking than those with secondary and university education. Subjects suffering from depressive disorder were more likely to smoke in comparison to subjects suffering from schizophrenia spectrum and other psychotic disorders. Smoking cessation: 58% of the current smokers admitted that they had made at least one attempt to quit smoking in the past 12 months and 42% reported that they will try to quit smoking in next six months. Smokers have placed an opinion that by increasing the cost of cigarettes, and reducing the availability of cigarettes, and increasing the awareness about the health impacts of smoking could encourage smoking cessation. Past smokers claim that self-determination/motivation, family and spouse support, substitution of smoking with other type of foods helped them in cessation of smoking. Constant and constituent motivation of smokers by promoting awareness of smoking cessation educational programmes and policy changes are crucial in achieving successful cessation.