Skip to main content
Top
Published in: International Journal of Mental Health Systems 1/2018

Open Access 01-12-2018 | Research

Gender differences and risk factors for smoking among patients with various psychiatric disorders in Saudi Arabia: a cross-sectional study

Authors: Fahad D. Alosaimi, Mohammed Abalhassan, Bandar Alhaddad, Ebtihaj O. Fallata, Abdulhadi Alhabbad, Rabab Alshenqiti, Mohammed Z. Alassiry

Published in: International Journal of Mental Health Systems | Issue 1/2018

Login to get access

Abstract

Background

The higher prevalence of smoking among psychiatric patients is well established. However, gender-specific associations have rarely been the focus of studies among patients with various psychiatric disorders. The aim of this study was to estimate the gender-specific prevalence of current smoking by psychiatric patients and its association with various psychiatric disorders and the use of psychotropic medications.

Methods

A cross-sectional observational study was performed between July 2012 and June 2014. Patients were recruited from six hospitals located in the five regions of Saudi Arabia.

Results

Of the 1193 patients, 402 (33.7%) were current smokers. The incidence of current smoking was much higher among males than females (58.3% versus 6.7%, p < 0.001). In one or both genders, current smoking was associated with marital status, education, family income, residence, obesity, physical activity, substance abuse, inpatient status, previous psychiatric hospitalization, and age at onset of psychiatric illness. In both gender, smoking was higher in patients who had a secondary psychiatric disorder (66.7% versus 37.5%, respectively), those who had a primary psychotic disorder (63.7% versus 12.3%), and those taking antipsychotic medication (64.1% versus 8.3%) but lower in patients who had a primary depressive disorder (40.3% versus 4.3%), those who had a primary anxiety disorder (45.8% versus 0.0%), and those taking antidepressant medications (53.7% versus 3.6%). In a multivariate analysis adjusted for demographic/clinical characteristics and psychiatric disorders, current smoking was independently associated with primary psychotic disorders in females (OR = 3.47, 1.45–8.27, p = 0.005) but not in males. In a multivariate analysis adjusted for demographic/clinical characteristics and psychotropic medications, current smoking was independently associated with antipsychotic medication use in males (OR = 1.79, 1.10–2.93, p = 0.020). Current smoking was strongly associated with substance abuse in both univariate and multivariate analyses.

Conclusion

The prevalence of current smoking is high with marked gender difference in a large sample of mixed psychiatric patients in Saudi Arabia. Smoking-cessation programs may be urgently needed for these vulnerable patients.
Literature
2.
go back to reference Bassiony MM. Smoking in Saudi Arabia. Saudi Med J. 2009;30:876–81.PubMed Bassiony MM. Smoking in Saudi Arabia. Saudi Med J. 2009;30:876–81.PubMed
3.
go back to reference WHO. WHO global report on trends in tobacco smoking 2000–2025. Geneva: World Health Organization; 2015. WHO. WHO global report on trends in tobacco smoking 2000–2025. Geneva: World Health Organization; 2015.
4.
go back to reference Al-Khashan HI, Al Sabaan FS, Al Nasser HS, Al Buraidi AA, Al Awad AD, Horaib GB, et al. The prevalence of smoking and its associated factors among military personnel in Kingdom of Saudi Arabia: a national study. J Fam Community Med. 2014;21:147–53.CrossRef Al-Khashan HI, Al Sabaan FS, Al Nasser HS, Al Buraidi AA, Al Awad AD, Horaib GB, et al. The prevalence of smoking and its associated factors among military personnel in Kingdom of Saudi Arabia: a national study. J Fam Community Med. 2014;21:147–53.CrossRef
5.
go back to reference Al-Haddad NS, Al-Habeeb TA, Abdelgadir MH, Al-Ghamdy YS, Qureshi NA. Smoking patterns among primary health care attendees, Al-Qassim region, Saudi Arabia. East Mediterr Health J. 2003;9:911–22.PubMed Al-Haddad NS, Al-Habeeb TA, Abdelgadir MH, Al-Ghamdy YS, Qureshi NA. Smoking patterns among primary health care attendees, Al-Qassim region, Saudi Arabia. East Mediterr Health J. 2003;9:911–22.PubMed
6.
go back to reference Siddiqui S, Ogbeide DO, Al Khalifa I. Smoking in a Saudi community: prevalance, influencing factors, and risk perception. Fam Med. 2001;33:367–70.PubMed Siddiqui S, Ogbeide DO, Al Khalifa I. Smoking in a Saudi community: prevalance, influencing factors, and risk perception. Fam Med. 2001;33:367–70.PubMed
7.
8.
go back to reference Aubin HJ, Rollema H, Svensson TH, Winterer G. Smoking, quitting, and psychiatric disease: a review. Neurosci Biobehav Rev. 2012;36:271–84.CrossRefPubMed Aubin HJ, Rollema H, Svensson TH, Winterer G. Smoking, quitting, and psychiatric disease: a review. Neurosci Biobehav Rev. 2012;36:271–84.CrossRefPubMed
10.
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;284:2606–10.CrossRefPubMed Lasser K, Boyd JW, Woolhandler S, Himmelstein DU, McCormick D, Bor DH. Smoking and mental illness: a population-based prevalence study. JAMA. 2000;284:2606–10.CrossRefPubMed
11.
go back to reference Ma X, Xiang YT, Cai ZJ, Li SR, Xiang YQ, Guo HL, et al. Smoking and psychiatric disorders in the rural and urban regions of Beijing, China: a community-based survey. Drug Alcohol Depend. 2009;100:146–52.CrossRefPubMed Ma X, Xiang YT, Cai ZJ, Li SR, Xiang YQ, Guo HL, et al. Smoking and psychiatric disorders in the rural and urban regions of Beijing, China: a community-based survey. Drug Alcohol Depend. 2009;100:146–52.CrossRefPubMed
12.
go back to reference Döme P, Rihmer Z, Gonda X, Pestality P, Kovács G, Teleki Z, et al. Cigarette smoking and psychiatric disorders in Hungary. Int J Psychiatry Clin Pract. 2005;9:145–8.CrossRefPubMed Döme P, Rihmer Z, Gonda X, Pestality P, Kovács G, Teleki Z, et al. Cigarette smoking and psychiatric disorders in Hungary. Int J Psychiatry Clin Pract. 2005;9:145–8.CrossRefPubMed
13.
go back to reference Lineberry TW, Allen JD, Nash J, Galardy CW. Population-based prevalence of smoking in psychiatric inpatients: a focus on acute suicide risk and major diagnostic groups. Compr Psychiatry. 2009;50:526–32.CrossRefPubMedPubMedCentral Lineberry TW, Allen JD, Nash J, Galardy CW. Population-based prevalence of smoking in psychiatric inpatients: a focus on acute suicide risk and major diagnostic groups. Compr Psychiatry. 2009;50:526–32.CrossRefPubMedPubMedCentral
14.
go back to reference John U, Meyer C, Rumpf H-J, Hapke U. Smoking, nicotine dependence and psychiatric comorbidity—a population-based study including smoking cessation after three years. Drug Alcohol Depend. 2004;76:287–95.CrossRefPubMed John U, Meyer C, Rumpf H-J, Hapke U. Smoking, nicotine dependence and psychiatric comorbidity—a population-based study including smoking cessation after three years. Drug Alcohol Depend. 2004;76:287–95.CrossRefPubMed
17.
go back to reference Fagerström K, Aubin HJ. Management of smoking cessation in patients with psychiatric disorders. Curr Med Res Opin. 2009;25:511–8.CrossRefPubMed Fagerström K, Aubin HJ. Management of smoking cessation in patients with psychiatric disorders. Curr Med Res Opin. 2009;25:511–8.CrossRefPubMed
18.
go back to reference Cristina LO, Carlos R, Laia M, Miguel C. Smoking in affective psychosis: review about nicotine use in bipolar and schizoaffective disorders. Adicciones. 2011;23:65–75.CrossRef Cristina LO, Carlos R, Laia M, Miguel C. Smoking in affective psychosis: review about nicotine use in bipolar and schizoaffective disorders. Adicciones. 2011;23:65–75.CrossRef
19.
go back to reference Ch T, Kardaras K, Kontaxakis V. Smoking in patients with psychiatric disorders: effects on their psychopathology and quality of life. Psychiatrike. 2008;19:306–12. Ch T, Kardaras K, Kontaxakis V. Smoking in patients with psychiatric disorders: effects on their psychopathology and quality of life. Psychiatrike. 2008;19:306–12.
20.
go back to reference Poirier MF, Canceil O, Baylé F, Millet B, Bourdel MC, Moatti C, et al. Prevalence of smoking in psychiatric patients. Prog Neuropsychopharmacol Biol Psychiatry. 2002;26:529–37.CrossRefPubMed Poirier MF, Canceil O, Baylé F, Millet B, Bourdel MC, Moatti C, et al. Prevalence of smoking in psychiatric patients. Prog Neuropsychopharmacol Biol Psychiatry. 2002;26:529–37.CrossRefPubMed
22.
go back to reference Al-Habeeb TA, Qureshi NA. Smoking among male psychiatric outpatients in Saudi Arabia. Ann Saudi Med. 2000;20:218–23.CrossRefPubMed Al-Habeeb TA, Qureshi NA. Smoking among male psychiatric outpatients in Saudi Arabia. Ann Saudi Med. 2000;20:218–23.CrossRefPubMed
24.
go back to reference Hales RE, Yudofsky SC, Gabbard GO, American Psychiatric Publishing. The American psychiatric publishing textbook of psychiatry. Washington, D.C.: American Psychiatric Publishing; 2008. Hales RE, Yudofsky SC, Gabbard GO, American Psychiatric Publishing. The American psychiatric publishing textbook of psychiatry. Washington, D.C.: American Psychiatric Publishing; 2008.
25.
go back to reference American Psychiatric Association. Diagnostic and statistical manual of mental disorders. Washington, D.C.: American Psychiatric Association; 2000. American Psychiatric Association. Diagnostic and statistical manual of mental disorders. Washington, D.C.: American Psychiatric Association; 2000.
26.
27.
go back to reference Hamadeh RR, Al Ansari A, Jahrami H, Al Offi A. Cigarette and waterpipe smoking among adult patients with severe and persistent mental illness in Bahrain: a comparison with the national non-communicable diseases risk factors survey. BMC Res Notes. 2016;9:77.CrossRefPubMedPubMedCentral Hamadeh RR, Al Ansari A, Jahrami H, Al Offi A. Cigarette and waterpipe smoking among adult patients with severe and persistent mental illness in Bahrain: a comparison with the national non-communicable diseases risk factors survey. BMC Res Notes. 2016;9:77.CrossRefPubMedPubMedCentral
28.
go back to reference Barros FCRD, Melo APS, Cournos F, Cherchiglia ML, Peixoto ERDM, Guimarães MDC. Cigarette smoking among psychiatric patients in Brazil. Cad Saude Publica. 2014;30:1195–206.CrossRefPubMed Barros FCRD, Melo APS, Cournos F, Cherchiglia ML, Peixoto ERDM, Guimarães MDC. Cigarette smoking among psychiatric patients in Brazil. Cad Saude Publica. 2014;30:1195–206.CrossRefPubMed
29.
go back to reference Umene-Nakano W, Yoshimura R, Hoshuyama T, Yoshii C, Hayashi K, Nakano H, et al. Current smoking rate in patients with psychiatric disorders in Japan: questionnaire survey. Psychiatry Res. 2013;210:268–73.CrossRefPubMed Umene-Nakano W, Yoshimura R, Hoshuyama T, Yoshii C, Hayashi K, Nakano H, et al. Current smoking rate in patients with psychiatric disorders in Japan: questionnaire survey. Psychiatry Res. 2013;210:268–73.CrossRefPubMed
30.
go back to reference Milani HS, Kharaghani R, Safa M, Samadi R, Farhadi MH, Ardakani MRK, et al. Pattern of smoking and nicotine dependence in patients with psychiatric disorders. Tanaffos. 2012;11:55–60.PubMedPubMedCentral Milani HS, Kharaghani R, Safa M, Samadi R, Farhadi MH, Ardakani MRK, et al. Pattern of smoking and nicotine dependence in patients with psychiatric disorders. Tanaffos. 2012;11:55–60.PubMedPubMedCentral
31.
go back to reference Chandra PS, Carey MP, Carey KB, Jairam KR, Girish NS, Rudresh HP. Prevalence and correlates of tobacco use and nicotine dependence among psychiatric patients in India. Addict Behav. 2005;30:1290–9.CrossRefPubMedPubMedCentral Chandra PS, Carey MP, Carey KB, Jairam KR, Girish NS, Rudresh HP. Prevalence and correlates of tobacco use and nicotine dependence among psychiatric patients in India. Addict Behav. 2005;30:1290–9.CrossRefPubMedPubMedCentral
32.
go back to reference Vanable PA, Carey MP, Carey KB, Maisto SA. Smoking among psychiatric outpatients: relationship to substance use, diagnosis, and illness severity. Psychol Addict Behav. 2003;17:259–65.CrossRefPubMedPubMedCentral Vanable PA, Carey MP, Carey KB, Maisto SA. Smoking among psychiatric outpatients: relationship to substance use, diagnosis, and illness severity. Psychol Addict Behav. 2003;17:259–65.CrossRefPubMedPubMedCentral
34.
go back to reference Abdalla AM, Al-Kaabba AF, Saeed AA, Abdulrahman BM, Raat H. Gender differences in smoking behavior among adolescents in Saudi Arabia. Saudi Med J. 2007;28:1102–8.PubMed Abdalla AM, Al-Kaabba AF, Saeed AA, Abdulrahman BM, Raat H. Gender differences in smoking behavior among adolescents in Saudi Arabia. Saudi Med J. 2007;28:1102–8.PubMed
35.
go back to reference Al-Turki KA, Al-Baghli NA, Al-Ghamdi AJ, El-Zubaier AG, Al-Ghamdi R, Alameer MM. Prevalence of current smoking in Eastern province,Saudi Arabia. East Mediterr Health J. 2010;16:671–6.CrossRefPubMed Al-Turki KA, Al-Baghli NA, Al-Ghamdi AJ, El-Zubaier AG, Al-Ghamdi R, Alameer MM. Prevalence of current smoking in Eastern province,Saudi Arabia. East Mediterr Health J. 2010;16:671–6.CrossRefPubMed
36.
go back to reference Cooper J, Mancuso SG, Borland R, Slade T, Galletly C, Castle D. Tobacco smoking among people living with a psychotic illness: the second Australian survey of psychosis. Aust N Z J Psychiatry. 2012;46:851–63.CrossRefPubMed Cooper J, Mancuso SG, Borland R, Slade T, Galletly C, Castle D. Tobacco smoking among people living with a psychotic illness: the second Australian survey of psychosis. Aust N Z J Psychiatry. 2012;46:851–63.CrossRefPubMed
37.
go back to reference Keizer I, Gex-Fabry M, Eytan A, Bertschy G. Smoking in psychiatric inpatients: association with working status, diagnosis, comorbid substance abuse and history of suicide attempts. Addict Behav. 2009;34:815–20.CrossRefPubMed Keizer I, Gex-Fabry M, Eytan A, Bertschy G. Smoking in psychiatric inpatients: association with working status, diagnosis, comorbid substance abuse and history of suicide attempts. Addict Behav. 2009;34:815–20.CrossRefPubMed
38.
go back to reference Kendler KS, Prescott CA, Myers J, Neale MC. The structure of genetic and environmental risk factors for common psychiatric and substance use disorders in men and women. Arch Gen Psychiatry. 2003;60:929.CrossRefPubMed Kendler KS, Prescott CA, Myers J, Neale MC. The structure of genetic and environmental risk factors for common psychiatric and substance use disorders in men and women. Arch Gen Psychiatry. 2003;60:929.CrossRefPubMed
39.
go back to reference Morisano D, Wing VC, Sacco KA, Arenovich T, George TP. Effects of tobacco smoking on neuropsychological function in schizophrenia in comparison to other psychiatric disorders and non-psychiatric controls. Am J Addict. 2013;22:46–53.CrossRefPubMed Morisano D, Wing VC, Sacco KA, Arenovich T, George TP. Effects of tobacco smoking on neuropsychological function in schizophrenia in comparison to other psychiatric disorders and non-psychiatric controls. Am J Addict. 2013;22:46–53.CrossRefPubMed
42.
go back to reference Barnes M, Lawford BR, Burton SC, Heslop KR, Noble EP, Hausdorf K, et al. Smoking and schizophrenia: is symptom profile related to smoking and which antipsychotic medication is of benefit in reducing cigarette use? Aust N Z J Psychiatry. 2006;40:575–80.CrossRefPubMed Barnes M, Lawford BR, Burton SC, Heslop KR, Noble EP, Hausdorf K, et al. Smoking and schizophrenia: is symptom profile related to smoking and which antipsychotic medication is of benefit in reducing cigarette use? Aust N Z J Psychiatry. 2006;40:575–80.CrossRefPubMed
43.
go back to reference Lowe EJ, Ackman ML. Impact of tobacco smoking cessation on stable clozapine or olanzapine treatment. Ann Pharmacother. 2010;44:727–32.CrossRefPubMed Lowe EJ, Ackman ML. Impact of tobacco smoking cessation on stable clozapine or olanzapine treatment. Ann Pharmacother. 2010;44:727–32.CrossRefPubMed
48.
go back to reference Mitchell AJ, Vancampfort D, De Hert M, Stubbs B. Do people with mental illness receive adequate smoking cessation advice? A systematic review and meta-analysis. Gen Hosp Psychiatry. 2015;37:14–23.CrossRefPubMed Mitchell AJ, Vancampfort D, De Hert M, Stubbs B. Do people with mental illness receive adequate smoking cessation advice? A systematic review and meta-analysis. Gen Hosp Psychiatry. 2015;37:14–23.CrossRefPubMed
Metadata
Title
Gender differences and risk factors for smoking among patients with various psychiatric disorders in Saudi Arabia: a cross-sectional study
Authors
Fahad D. Alosaimi
Mohammed Abalhassan
Bandar Alhaddad
Ebtihaj O. Fallata
Abdulhadi Alhabbad
Rabab Alshenqiti
Mohammed Z. Alassiry
Publication date
01-12-2018
Publisher
BioMed Central
Published in
International Journal of Mental Health Systems / Issue 1/2018
Electronic ISSN: 1752-4458
DOI
https://doi.org/10.1186/s13033-018-0201-7

Other articles of this Issue 1/2018

International Journal of Mental Health Systems 1/2018 Go to the issue