Nicotine reliance in schizophrenic and bipolar disorder patients: a comparative study

ABSTRACT

We aimed to determine the prevalence of smoking and the severity of nicotine reliance in patients with schizophrenia and bipolar disorder and find the relationship between smoking status and some sociodemographic and clinical characteristics. A sample of consecutive admissions of all patients with schizophrenia [n=70] and bipolar disorder [n=46] admitted to psychiatric units of a private hospital over a period of three months was recruited. Patients were diagnosed according to DSM-IV. Demographic and clinical data were collected. The total sample [n=116, male 75.9%] was assessed as regards the cigarette smoking status and the age of initiation of smoking. For the smokers, the severity of nicotine reliance was assessed using the Fagerstrom tolerance scale. A control group [n30] smokers, who were age and sex matched with the case smokers, were assessed for the severity of nicotine dependence. 58.6% of patients with schizophrenia were smokers [60% of them were dependent] compared to 32.6% of patients with bipolar disorder 938.5% were dependent]. In the total case sample, smokers differed significantly from non smokers as regards the diagnosis, sex and history of substance abuse and their age of initiation of smoking correlated with the age of onset of the disorder. 83.6% of cases that were current smokers initiated smoking at or before the onset of the disorder [72.7% before]. Schizophrenia smokers initiated smoking significantly earlier than control smokers denoting severer nicotine reliance but there were no significant difference between schizophrenia and bipolar smokers on the scale score. Nicrotine reliance is higher in patients with schizophrenia and bipolar disorder compared to normal controls. Factors that is higher in patients with schizophrenia and bipolar disorder compared to normal controls. Factors that influence cigarette smoking in psychiatric patients include diagnosis, sex and history of substance abuse. Age of initiation of smoking may be related to the onset of the disorder