Tobacco addiction in the psychiatric population and in the general population.
Renata Marques de Oliveira, Jair Lício Ferreira Santos, Antonia Regina Ferreira Furegato
PMID 29211192WHAT IT FOUND
Psychiatric patients who smoked were more often highly dependent than primary-care smokers.
Dependence was also more common in men, people aged 49 or under, and those at high suicide risk. Nurses can assess dependence and suicide risk together.
Key findings
01Psychiatric smokers were more often medium or high dependent than primary-care smokers.
02After adjustment, high dependence was more common in men, people aged 49 or under, severe mental disorders, anxiety or other disorders, and high suicide risk.
03Antipsychotic use and illicit substance use were no longer detected as independent associations after adjustment.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The study is cross-sectional, so it cannot show that mental disorders, suicide risk, or substance use cause higher nicotine dependence. It included only current smokers from three services in one Brazilian municipality, so it says nothing about non-smokers, ex-smokers, or other settings. The sample was small and uneven across sites, with 134 smokers total, so some estimates may be unstable. Nicotine dependence was split into high and lower groups at a cutoff, so patients just below and just above the cutoff may be similar. Only the main psychiatric diagnosis was recorded, so the authors could not assess whether additional diagnoses increased dependence.
The easy way to misread this
Do not conclude that mental disorders or suicide risk cause nicotine dependence. The study measured dependence and these factors at one time, so it shows association, not cause.