Tobacco dependence and associated factors among psychiatric patients attending services at jimma university teaching hospital, south west Ethiopia

Abstract

Background: Tobacco smoking is health care issue in developed as well as in developing countries. Research showed that, tobacco smoking among people with psychiatric disorders is significantly higher than in the general population. Tobacco smoking has negative effects on physical, mental and the financial well-being of people with mental health problems. However, there are few studies done on tobacco dependence and associated factors among psychiatric patients in sub–Saharan African countries including Ethiopia. Objective: To assess the prevalence of tobacco dependence and associated factors among psychiatric patients attending services at Jimma University Teaching Hospital. Method: Across-sectional study was used among psychiatric patients. Data was collected by interviewing 305 male and 117 female psychiatric patients who are attending service at Jimma University Teaching Hospital psychiatric clinic. The Fagerstrom Test for Nicotine Dependence (FTND) was used to assess tobacco dependence. Also, we have used CAGE to assess alcohol use disorders. After double entry verification using Epi-Data version 3.1, data was exported to and analyzed using SPSS version 20 for windows. The association between dependent and independent variables was assessed by using bivariate and multivariate logistic regression. Variables with p-value less than 0.05 in the multivariate logistic regression were considered as independent predictors of tobacco dependence. Results: The general prevalence of current tobacco dependence among the study participants were 18.5%. Of this, 10.7%, 5.5% and 2.4% of them had moderate, high and very high level of tobacco dependence, respectively. All tobacco dependent patients were males. In multivariate logistic regression analysis it was found that, less attending a place of worship, high school education, alcohol use disorder, daily khat chewing, having friends who smoke tobacco and being diagnosed as schizophrenia were positively associated with tobacco dependence. Conclusion: High prevalence of tobacco dependence was found among schizophrenic patients followed by patients with bipolar disorders. Therefore, psychotherapy and pharmacotherapy is crucial to reduce tobacco dependence and tobacco related medical illness.