Demographic correlates of nicotine dependence in psychiatric patients

Yogendra Singh, Anil Sisodia, Anil Gaur, Vikrant Agarwal


Background: Tobacco and nicotine dependence has high prevalence in patients with psychiatric disorders. The present study was conducted to delineate demographic correlates of tobacco and nicotine dependence in psychiatric patients.

Methods: 102 patients were sampled from Institute of Mental Health and Hospital, Agra. Fagerström Test for Nicotine Dependence for Smoking, Fagerström Test for Nicotine Dependence for Smokeless Tobacco, The Drug Abuse Screening Test (DAST), Alcohol Use Disorders Identification Test (AUDIT) were used along with a proforma for recording demographic and clinical details of the patients.

Results: The results suggested that the severity of nicotine dependence in total sample was as Very Low in 2.9%, Low in 15.7%, medium in 42.2%, and High in 39.2%. The results of association between demographic variables and nicotine dependence suggested that there was statistically significant association between nicotine dependence and gender, place of residence, marital status, type of family, annual income, history of mental illness, History of substance use and duration of tobacco use.

Conclusions: The medium and high level of nicotine dependence amount to 81.40% sample is of true concern which warrant for an active intervention for tobacco cessation programs in majority of the patients.


Correlates of nicotine dependence, Fagerström test for nicotine dependence, Nicotine dependence, Tobacco and mental health, Tobacco cessation program

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Islam K, Saha I, Saha R, Samim Khan SA, Thakur R, Shivam S. Predictors of quitting behaviour with special reference to nicotine dependence among adult tobacco-users in a slum of Burdwan district, West Bengal, India. Indian J Med Res. 2014;139(4):638-42.

Bedi R, Gilthorpe MS. The prevalence of betel-quid and tobacco chewing among the Bangladeshi community resident in a United Kingdom area of multiple deprivation. Prim Dent Care. 1995;2(2):39-42.

Summers RM, Williams SA, Curzon ME. The use of tobacco and betel quid ('pan') among Bangladeshi women in West Yorkshire. Community Dent Health. 1994;11(1):12-6.

Lim SS, Vos T, Flaxman AD, Danaei G, Shibuya K, Adair-Rohani H, et al. A comparative risk assessment of burden of disease and injury attributable to 67 risk factors and risk factor clusters in 21 regions, 1990-2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet. 2012;380(9859):2224-60.

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.

Sinha DN, Palipudi KM, Gupta PC, Singhal S, Ramasundarahettige C, Jha P, Indrayan A, Asma S, Vendhan G. Smokeless tobacco use: a meta-analysis of risk and attributable mortality estimates for India. Indian J Cancer. 2014;51 Suppl 1:S73-7.

Jain R, Majumder P, Gupta T. Pharmacological intervention of nicotine dependence. Biomed Res Int. 2013;2013:278392.

Regier DA, Farmer ME, Rae DS, Locke BZ, Keith SJ, Judd LL, Goodwin FK. Comorbidity of mental disorders with alcohol and other drug abuse. Results from the Epidemiologic Catchment Area (ECA) Study. JAMA. 1990;264(19):2511-8.

Smith PH, Mazure CM, McKee SA. Smoking and mental illness in the U.S. population. Tob Control. 2014;23(e2):e147-53.

Degenhardt L, Hall W. The relationship between tobacco use, substance-use disorders and mental health: results from the National Survey of Mental Health and Well-being. Nicotine Tob Res. 2001;3(3):225-34.

Brown RA, Lewinsohn PM, Seeley JR, Wagner EF. Cigarette smoking, major depression, and other psychiatric disorders among adolescents. J Am Acad Child Adolesc Psychiatry. 1996;35(12):1602-10.

Pomerleau CS, Zucker AN, Namenek Brouwer RJ, Pomerleau OF, Stewart AJ. Race differences in weight concerns among women smokers: results from two independent samples. Addict Behav. 2001;26(5):651-63.

de Leon J, Diaz FJ. A meta-analysis of worldwide studies demonstrates an association between schizophrenia and tobacco smoking behaviors. Schizophr Res. 2005;76(2-3):135-57.

Srinivasan TN, Thara R. Smoking in schizophrenia -- all is not biological. Schizophr Res. 2002;56(1-2):67-74.

Subramaniam M, Cheok C, Lee IM, Pek E, Verma S, Wong J, Chong SA. Nicotine dependence and psychiatric disorders among young males in Singapore. Nicotine Tob Res. 2009;11(9):1107-13.

Talati A, Keyes KM, Hasin DS. Changing relationships between smoking and psychiatric disorders across twentieth century birth cohorts: clinical and research implications. Mol Psychiatry. 2016;21(4):464-71.

Aguilar MC, Gurpegui M, Diaz FJ, de Leon J. Nicotine dependence and symptoms in schizophrenia: naturalistic study of complex interactions. Br J Psychiatry. 2005;186:215-21.

Fu Q, Vaughn MG, Wu LT, Heath AC. Psychiatric correlates of snuff and chewing tobacco use. PLoS One. 2014;9(12):e113196.

de Leon J, Dadvand M, Canuso C, White AO, Stanilla JK, Simpson GM. Schizophrenia and smoking: an epidemiological survey in a state hospital. Am J Psychiatry. 1995;152(3):453-5.

Shinozaki Y, Nakao M, Takeuchi T, Yano E. Smoking rates among schizophrenia patients in Japan. Psychiatry Res. 2011;186(2-3):165-9.

Bandiera FC, Anteneh B, Le T, Delucchi K, Guydish J. Tobacco-related mortality among persons with mental health and substance abuse problems. PLoS One. 2015;10(3):e0120581.

Heatherton TF, Kozlowski LT, Frecker RC, Fagerström KO. The Fagerström Test for Nicotine Dependence: a revision of the Fagerström Tolerance Questionnaire. Br J Addict. 1991;86(9):1119-27.

D'Souza G, Rekha DP, Sreedaran P, Srinivasan K, Mony PK. Clinico-epidemiological profile of tobacco users attending a tobacco cessation clinic in a teaching hospital in Bangalore city. Lung India. 2012;29(2):137-42.

Manimunda SP, Benegal V, Sugunan AP, Jeemon P, Balakrishna N, Thennarusu K, Pandian D, Pesala KS. Tobacco use and nicotine dependency in a cross-sectional representative sample of 18,018 individuals in Andaman and Nicobar Islands, India. BMC Public Health. 2012;12:515.

Skinner HA. The drug abuse screening test. Addict Behav. 1982;7(4):363-71.

WHO. AUDIT, World Health Organization, 2001

Xaxa V, Ramanathan U, Bara J, Misra KK, Bang A, Basant S, et al. Census of India, 2011 Provisional Population Totals – Orissa – Data Sheet Government of India. Gov India. 2013.

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(7):1290-9.

Myles N, Newall HD, Curtis J, Nielssen O, Shiers D, Large M. Tobacco use before, at, and after first-episode psychosis: a systematic meta-analysis. J Clin Psychiatry. 2012;73(4):468-75.

Cohen, S., & Williamson, G. Perceived Stress in a Probability Sample of the United States. In S. Spacapan, & S. Oskamp (Eds.), The Social Psychology of Health: Claremont Symposium on Applied Social Psychology Newbury Park, CA: Sage. 1988;pp. 31-67.

Dollar KM, Homish GG, Kozlowski LT, Leonard KE. Spousal and alcohol-related predictors of smoking cessation: a longitudinal study in a community sample of married couples. Am J Public Health. 2009;99(2):231-3.

Rani M, Bonu S, Jha P, Nguyen SN, Jamjoum L. Tobacco use in India: prevalence and predictors of smoking and chewing in a national cross sectional household survey. Tob Control. 2003;12(4):e4.

Grossman M, Bowie CR, Lepage M, Malla AK, Joober R, Iyer SN. Smoking status and its relationship to demographic and clinical characteristics in first episode psychosis. J Psychiatr Res. 2017;85:83-90.

Kotov R, Guey LT, Bromet EJ, Schwartz JE. Smoking in schizophrenia: diagnostic specificity, symptom correlates, and illness severity. Schizophr Bull. 2010;36(1):173-81.

Corvin A, O'Mahony E, O'Regan M, Comerford C, O'Connell R, Craddock N, Gill M. Cigarette smoking and psychotic symptoms in bipolar affective disorder. Br J Psychiatr. 2001;179:35-8.