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Published in: BMC Psychiatry 1/2016

Open Access 01-12-2016 | Research article

Cigarette smoking, nicotine dependence, and motivation to quit smoking in South African male psychiatric inpatients

Authors: Jean-Louis Du Plooy, Muiruri Macharia, Chris Verster

Published in: BMC Psychiatry | Issue 1/2016

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Abstract

Background

Smoking is the leading cause of preventable death worldwide and the prevalence is particularly high among psychiatric patients but recent international studies demonstrated that psychiatric patients are able and motivated to quit. The aim of this study was to evaluate cigarette smoking, nicotine dependence, and motivation for smoking cessation in male psychiatric inpatients in a sample of South African acute-care male psychiatric inpatients.

Methods

All inpatients admitted during a 2-month period (April to May 2016) to the Stikland Hospital Acute Male Admissions Unit in Cape Town, Western Cape, were included. Subjects completed a survey including a set of tests: Global Adult Tobacco Survey (GATS), the Fagerström Test for Nicotine Dependence (FTND), and the Decisional Balance for Cigarette Smoking (DBCS) (6-item version). Demographic data were obtained from patients’ clinical charts.

Results

Among the 160 new inpatients, 72.5% (n = 116) completed the survey. Of the 116 participants, 91.4% (n = 106) were current smokers of whom 82% (n = 87) smoked daily and 55.6% (n = 59) were identified as having high nicotine dependence (FTND ≥ 6). Although a large majority (71.7%; n = 76) of current smokers expressed positive perceptions regarding smoking, a notable proportion (59.4%; n = 63) still attempted to quit the habit in the preceding 12 months and daily smokers were less likely to quit. However, only a minor proportion of all current (43.4%; n = 46) and specifically daily (40.2%; n = 35) smokers were advised on smoking cessation by a health worker.

Conclusion

This study confirms that, similar to populations elsewhere, rates of cigarette smoking among psychiatric inpatients in South Africa is exceedingly high. While patients are motivated to quit smoking, few were provided with the necessary advice. Our findings provide further support for the integration of smoking cessation support in mental health care.
Literature
2.
go back to reference Lasser K, Boyd JW, Woolhandler S, Himmelstein DU, McCormick D, Bor DH. Smoking and mental illness: a population-based prevalence study. JAMA. 2000;284(20):2606–10.CrossRefPubMed Lasser K, Boyd JW, Woolhandler S, Himmelstein DU, McCormick D, Bor DH. Smoking and mental illness: a population-based prevalence study. JAMA. 2000;284(20):2606–10.CrossRefPubMed
3.
go back to reference Lawrence D, Mitrou F, Zubrick SR. Smoking and mental illness: results from population surveys in Australia and the United States. BMC Public Health. 2009;9(1):1.CrossRef Lawrence D, Mitrou F, Zubrick SR. Smoking and mental illness: results from population surveys in Australia and the United States. BMC Public Health. 2009;9(1):1.CrossRef
4.
go back to reference Kumari V, Postma P. Nicotine use in schizophrenia: the self-medication hypotheses. Neurosci Biobehav Rev. 2005;29(6):1021–34.CrossRefPubMed Kumari V, Postma P. Nicotine use in schizophrenia: the self-medication hypotheses. Neurosci Biobehav Rev. 2005;29(6):1021–34.CrossRefPubMed
5.
go back to reference Jochelson KA, Majrowski BI. Clearing the air: debating smoke-free policies in psychiatric units. London: King’s Fund; 2006. Jochelson KA, Majrowski BI. Clearing the air: debating smoke-free policies in psychiatric units. London: King’s Fund; 2006.
6.
7.
go back to reference Keltner NL, Grant JS. Smoke, smoke, smoke that cigarette. Perspect Psychiatr Care. 2006;42(4):256–61.CrossRefPubMed Keltner NL, Grant JS. Smoke, smoke, smoke that cigarette. Perspect Psychiatr Care. 2006;42(4):256–61.CrossRefPubMed
9.
go back to reference Leung J, Gartner C, Hall W, Lucke J, Dobson A. A longitudinal study of the bi-directional relationship between tobacco smoking and psychological distress in a community sample of young Australian women. Psychol Med. 2012;42(06):1273–82.CrossRefPubMed Leung J, Gartner C, Hall W, Lucke J, Dobson A. A longitudinal study of the bi-directional relationship between tobacco smoking and psychological distress in a community sample of young Australian women. Psychol Med. 2012;42(06):1273–82.CrossRefPubMed
10.
go back to reference Jamal M, Van der Does AW, Penninx BW, Cuijpers P. Age at smoking onset and the onset of depression and anxiety disorders. Nicotine Tob Res. 2011;13(9):809–19.CrossRefPubMed Jamal M, Van der Does AW, Penninx BW, Cuijpers P. Age at smoking onset and the onset of depression and anxiety disorders. Nicotine Tob Res. 2011;13(9):809–19.CrossRefPubMed
11.
go back to reference Taylor G, McNeill A, Girling A, Farley A, Lindson-Hawley N, Aveyard P. Change in mental health after smoking cessation: systematic review and meta-analysis. BMJ. 2014;348:1151.CrossRef Taylor G, McNeill A, Girling A, Farley A, Lindson-Hawley N, Aveyard P. Change in mental health after smoking cessation: systematic review and meta-analysis. BMJ. 2014;348:1151.CrossRef
12.
go back to reference de Leon J, Armstrong SC, Cozza KL. The dosing of atypical antipsychotics. Psychosomatics. 2005;46(3):262–73.CrossRefPubMed de Leon J, Armstrong SC, Cozza KL. The dosing of atypical antipsychotics. Psychosomatics. 2005;46(3):262–73.CrossRefPubMed
13.
go back to reference Warner KE, Burns DM. Hardening and the hard-core smoker: concepts, evidence, and implications. Nicotine Tob Res. 2003;5(1):37–48.CrossRefPubMed Warner KE, Burns DM. Hardening and the hard-core smoker: concepts, evidence, and implications. Nicotine Tob Res. 2003;5(1):37–48.CrossRefPubMed
14.
go back to reference Lawn SJ, Pols RG, Barber JG. Smoking and quitting: a qualitative study with community-living psychiatric clients. Soc Sci Med. 2002;54(1):93–104.CrossRefPubMed Lawn SJ, Pols RG, Barber JG. Smoking and quitting: a qualitative study with community-living psychiatric clients. Soc Sci Med. 2002;54(1):93–104.CrossRefPubMed
15.
go back to reference Siru R, Hulse GK, Tait RJ. Assessing motivation to quit smoking in people with mental illness: a review. Addiction. 2009;104(5):719–33.CrossRefPubMed Siru R, Hulse GK, Tait RJ. Assessing motivation to quit smoking in people with mental illness: a review. Addiction. 2009;104(5):719–33.CrossRefPubMed
17.
go back to reference Wye P, Bowman J, Wiggers J, Baker A, Carr V, Terry M, Knight J, Clancy R. Providing nicotine dependence treatment to psychiatric inpatients: the views of Australian nurse managers. J Psychiatr Ment Health Nurs. 2010;17(4):319–27.CrossRefPubMed Wye P, Bowman J, Wiggers J, Baker A, Carr V, Terry M, Knight J, Clancy R. Providing nicotine dependence treatment to psychiatric inpatients: the views of Australian nurse managers. J Psychiatr Ment Health Nurs. 2010;17(4):319–27.CrossRefPubMed
19.
go back to reference Peer N, Bradshaw D, Laubscher R, Steyn K. Trends in adult tobacco use from two South African demographic and health surveys conducted in 1998 and 2003. SAMJ. 2009;99(10):744–9.PubMed Peer N, Bradshaw D, Laubscher R, Steyn K. Trends in adult tobacco use from two South African demographic and health surveys conducted in 1998 and 2003. SAMJ. 2009;99(10):744–9.PubMed
20.
go back to reference Reddy P, James S, Sewpaul R, Yach D, Resnicow K, Sifunda S, Mthembu Z, Mbewu A. A decade of tobacco control: The South African case of politics, health policy, health promotion and behaviour change. SAMJ. 2013;103(11):835–40.CrossRefPubMed Reddy P, James S, Sewpaul R, Yach D, Resnicow K, Sifunda S, Mthembu Z, Mbewu A. A decade of tobacco control: The South African case of politics, health policy, health promotion and behaviour change. SAMJ. 2013;103(11):835–40.CrossRefPubMed
21.
go back to reference Lê Cook B, Wayne GF, Kafali EN, Liu Z, Shu C, Flores M. Trends in smoking among adults with mental illness and association between mental health treatment and smoking cessation. JAMA. 2014;311(2):172–82.CrossRef Lê Cook B, Wayne GF, Kafali EN, Liu Z, Shu C, Flores M. Trends in smoking among adults with mental illness and association between mental health treatment and smoking cessation. JAMA. 2014;311(2):172–82.CrossRef
23.
go back to reference Tobacco Products Control Act of 1993. Pretoria: Government Gazette; 1993. Tobacco Products Control Act of 1993. Pretoria: Government Gazette; 1993.
24.
go back to reference Tobacco Products Control Amendment Act No. 12 of 1999. Vol. 406. Pretoria: Government Gazette; 1999. Tobacco Products Control Amendment Act No. 12 of 1999. Vol. 406. Pretoria: Government Gazette; 1999.
25.
go back to reference Tobacco Products Control Amendment Act No. 23 of 2007. Vol. 512. Pretoria: Government Gazette; 2008. Tobacco Products Control Amendment Act No. 23 of 2007. Vol. 512. Pretoria: Government Gazette; 2008.
26.
go back to reference Tobacco Products Control Amendment Act No. 63 of 2008. Vol. 523. Pretoria: Government Gazette; 2009. Tobacco Products Control Amendment Act No. 63 of 2008. Vol. 523. Pretoria: Government Gazette; 2009.
28.
go back to reference Heatherton TF, Kozlowski LT, Frecker RC, Faferstrom KO. The Fagerström test for nicotine dependence: a revision of the Fagerstrom Tolerance Questionnaire. Br J Addict. 1991;86(9):1119–27.CrossRefPubMed Heatherton TF, Kozlowski LT, Frecker RC, Faferstrom KO. The Fagerström test for nicotine dependence: a revision of the Fagerstrom Tolerance Questionnaire. Br J Addict. 1991;86(9):1119–27.CrossRefPubMed
29.
go back to reference Velicer WF, DiClemente CC, Prochaska JO, Brandenburg N. Decisional balance measure for assessing and predicting smoking status. J Pers Soc Psychol. 1985;48(5):1279.CrossRefPubMed Velicer WF, DiClemente CC, Prochaska JO, Brandenburg N. Decisional balance measure for assessing and predicting smoking status. J Pers Soc Psychol. 1985;48(5):1279.CrossRefPubMed
30.
go back to reference IBM Corp. Released 2013. IBM SPSS Statistics for Windows, Version 22.0. Armonk: IBM Corp. IBM Corp. Released 2013. IBM SPSS Statistics for Windows, Version 22.0. Armonk: IBM Corp.
31.
go back to reference Reddy P, Zuma K, Shisana O, Jonas K, Sewpaul R. Prevalence of tobacco use among adults in South Africa: Results from the first South African National Health and Nutrition Examination Survey. SAMJ. 2015;105(8):648–55.CrossRefPubMed Reddy P, Zuma K, Shisana O, Jonas K, Sewpaul R. Prevalence of tobacco use among adults in South Africa: Results from the first South African National Health and Nutrition Examination Survey. SAMJ. 2015;105(8):648–55.CrossRefPubMed
32.
go back to reference de Leon J, Diaz FJ. A meta-analysis of worldwide studies demonstrates an association between schizophrenia and tobacco smoking behaviors. Schizophr Res. 2005;76(2):135–57.CrossRefPubMed de Leon J, Diaz FJ. A meta-analysis of worldwide studies demonstrates an association between schizophrenia and tobacco smoking behaviors. Schizophr Res. 2005;76(2):135–57.CrossRefPubMed
33.
go back to reference Ziaaddini H, Kheradmand A, Vahabi M. Prevalence of cigarette smoking in schizophrenic patients compared to other hospital admitted psychiatric patients. Addict Health. 2009;1(1):38–42. Ziaaddini H, Kheradmand A, Vahabi M. Prevalence of cigarette smoking in schizophrenic patients compared to other hospital admitted psychiatric patients. Addict Health. 2009;1(1):38–42.
34.
go back to reference Hughes JR, Helzer JE, Lindberg SA. Prevalence of DSM/ICD-defined nicotine dependence. Drug Alcohol Depend. 2006;85(2):91–102.CrossRefPubMed Hughes JR, Helzer JE, Lindberg SA. Prevalence of DSM/ICD-defined nicotine dependence. Drug Alcohol Depend. 2006;85(2):91–102.CrossRefPubMed
35.
go back to reference Solty H, Crockford D, White WD, Currie S. Cigarette smoking, nicotine dependence, and motivation for smoking cessation in psychiatric inpatients. Can J Psychiatry. 2009;54(1):36–45.CrossRefPubMed Solty H, Crockford D, White WD, Currie S. Cigarette smoking, nicotine dependence, and motivation for smoking cessation in psychiatric inpatients. Can J Psychiatry. 2009;54(1):36–45.CrossRefPubMed
36.
go back to reference de Leon J, Beco AE, Gurpegui M, et al. The association between high nicotine dependence and severe mental illness may be consistent across countries. J Clin Psychiatry. 2002;63:812–6.CrossRefPubMed de Leon J, Beco AE, Gurpegui M, et al. The association between high nicotine dependence and severe mental illness may be consistent across countries. J Clin Psychiatry. 2002;63:812–6.CrossRefPubMed
37.
go back to reference Prochaska JJ, Gill P, Hall SM. Treatment of tobacco use in an inpatient psychiatric setting. Psychiatr Serv. 2004;55:1265–70.CrossRefPubMed Prochaska JJ, Gill P, Hall SM. Treatment of tobacco use in an inpatient psychiatric setting. Psychiatr Serv. 2004;55:1265–70.CrossRefPubMed
38.
go back to reference Fiore MC, Jaen CR, Baker TB, et al. Treating Tobacco Use and Dependence: 2008 Update—Clinical Practice Guideline. Rockville: US Department of Health and Human Services, Public Health Service; 2008. Fiore MC, Jaen CR, Baker TB, et al. Treating Tobacco Use and Dependence: 2008 Update—Clinical Practice Guideline. Rockville: US Department of Health and Human Services, Public Health Service; 2008.
39.
go back to reference Himelhoch S, Daumit G. To whom do psychiatrists offer smoking-cessation counseling? Am J Psychiatry. 2003;160:2228–30.CrossRefPubMed Himelhoch S, Daumit G. To whom do psychiatrists offer smoking-cessation counseling? Am J Psychiatry. 2003;160:2228–30.CrossRefPubMed
40.
go back to reference Montoya ID, Herbeck DM, Svikis DS, Pincus HA. Identification and treatment of patients with nicotine problems in routine clinical psychiatry practice. Am J Addict. 2005;14:441–54.CrossRefPubMedPubMedCentral Montoya ID, Herbeck DM, Svikis DS, Pincus HA. Identification and treatment of patients with nicotine problems in routine clinical psychiatry practice. Am J Addict. 2005;14:441–54.CrossRefPubMedPubMedCentral
41.
go back to reference Prochaska JJ, Fromont SC, Hall SM. How prepared are psychiatry residents for treating nicotine dependence? Acad Psychiatry. 2005;29(3):256–61.CrossRefPubMed Prochaska JJ, Fromont SC, Hall SM. How prepared are psychiatry residents for treating nicotine dependence? Acad Psychiatry. 2005;29(3):256–61.CrossRefPubMed
43.
go back to reference Lawn SJ. Systemic barriers to quitting smoking among institutionalized public mental health services populations: a comparison of two Australian sites. Int J Soc Psychiatry. 2004;50(3):204–15.CrossRefPubMed Lawn SJ. Systemic barriers to quitting smoking among institutionalized public mental health services populations: a comparison of two Australian sites. Int J Soc Psychiatry. 2004;50(3):204–15.CrossRefPubMed
44.
go back to reference Lawn S, Condon J. Psychiatric nurses’ ethical stance on cigarette smoking by patients: determinants and dilemmas in their role in supporting cessation. Int J Ment Health Nurs. 2006;15(2):111–8.CrossRefPubMed Lawn S, Condon J. Psychiatric nurses’ ethical stance on cigarette smoking by patients: determinants and dilemmas in their role in supporting cessation. Int J Ment Health Nurs. 2006;15(2):111–8.CrossRefPubMed
45.
Metadata
Title
Cigarette smoking, nicotine dependence, and motivation to quit smoking in South African male psychiatric inpatients
Authors
Jean-Louis Du Plooy
Muiruri Macharia
Chris Verster
Publication date
01-12-2016
Publisher
BioMed Central
Published in
BMC Psychiatry / Issue 1/2016
Electronic ISSN: 1471-244X
DOI
https://doi.org/10.1186/s12888-016-1123-z

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