Association between cigarette smoking and suicide in psychiatric inpatients.

INTRODUCTION: Cigarette smoking is the single largest preventable cause of death and disability in the industrialized world and it causes at least 85% of lung cancers, chronic bronchitis and emphysema. In addition smokers are at a higher risk from psychiatric co-morbid illness such as depression and completed suicide. METHODS: We conducted a cross-sectional survey in which we targeted all patients with serious mental illness (SMI) who were admitted in Razi mental health Hospital in Tehran, Iran. We recruited 984 participants, who were receiving services from Razi mental health Hospital and hospitalized for at least two days between 21 July to 21 September, 2010. Nine hundred and fifty patients out of this figure were able to participate in our study. RESULTS: The final study sample (n = 950) consisted of 73.2% males and 26.8% females. The mean age was 45.31 (SD=13.7). A majority of participants (70%) was smoker. A history of never smoking was present for 25.2% of the study sample; while 4.8% qualified as former smokers and 70.0% as occasional or current smokers. Two hundred and nineteen participants had attempted suicide amongst them 102 (46.6%) once, 37 (16.9%) twice, and 80 (36.5%) attempted more than two times in their life time. In regression model, gender, age, and cigarette consumption were associated with previous suicide attempts and entered the model in this order as significant predictors. CONCLUSION: There is an association of cigarette smoking and suicide attempt in psychiatric inpatients. Current smoking, a simple clinical assessment, should trigger greater attention by clinicians to potential suicidality and become part of a comprehensive assessment of suicide risk.

The determinants of high school students smoking habits with special focus on teachers smoking in Iran: a population based study.

INTRODUCTION: Approval of smoking by friends and teachers is likely to increase the probability of smoking by the students. This study aims to determine whether adolescent smoking is associated with teachers or other students smoking, after controlling for confounders. MATERIALS & METHODS: In a cross sectional study, a representative sample of 4599 students in the third grade were selected from high schools in Tehran. A 21 item questionnaire was administered consisting of demographic and tobacco smoking habit questions. Pattern of adolescent tobacco smoking was compared between two sexes. Association between smoking behavior and perceived exposure to teachers smoking were assessed using bivariate and multivariate analyses, adjusting for parental, best friends and sibling smoking and sex. A multivariate logistic regression model was constructed and adjusted Odds Ratios were estimated. RESULTS: In total, 4591 students, aged 17 to 19 years, consisting of 2092 (45.6%) boys and 2499 (54.4%) girls, with the overall mean age of 17.53 +/- 0.59 years, were recruited. Of the students studied, 250 (12.1%) of boys and 131 (5.3%) of girls reported being current smokers (p = 0.001). The proportion of smoker and non-smoker students reporting to have been exposed to teachers smoking inside the school building was 209 (55.7%) and 1191 (29.3%), respectively (p = 0.001). Of those reporting being exposed to teachers smoking outdoors on school premises, 220 (58.7%) were smokers and 1205 (29.2%) were non-smokers (p = 0.001). After adjusting for sex, smoking habit of father, mother, brothers, sisters and best friends, adolescent perceived exposure to teachers smoking on school premises, but not inside school, was significantly associated with current smoking (OR = 2.1, 95 % CI:1. 7-2. 7). Adolescent exposure to best friend smoking was strongly associated with current smoking after adjusting for above variables (OR=6. 7, 95 % CI:5-9). CONCLUSION: Teachers smoking during school hours and best friend smoking are the two important determinants to be considered in any project aiming to establish tobacco-free schools.

Pattern of smoking and nicotine dependence in patients with psychiatric disorders.

BACKGROUND: Smoking prevalence is high among psychiatric patients. This study aimed to evaluate the prevalence of smoking, related factors and nicotine dependence in patients suffering from psychiatric disorders. MATERIALS AND METHODS: This analytical descriptive study was performed on patients who had been hospitalized for at least 2 days in Razi Hospital during 2010. Data were collected via an interview and the obtained information was recorded in a questionnaire. Fagerstrom test was also used. After determining the prevalence of smoking in these patients, the related factors and nicotine dependence were also evaluated using multiple logistic regression test and SPSS software. RESULTS: A total of 78.4% of men and 36.2% of women in this study were smokers and 64.4% had high nicotine dependence. Final logistic regression models showed that smoking was related with advanced age, male sexuality, hookah consumption, and depression. High nicotine dependence was correlated with hookah consumption and history of suicide attempt. CONCLUSION: Prevalence of smoking is higher among psychiatric patients compared to the public. Adequate intervention and strategies are necessary in these patients to promote smoking cessation.

Reduction of secondhand smoke exposure among healthy infants in Iran: randomized controlled trial.

INTRODUCTION: The objective of this study was to assess whether counseling both mothers and fathers reduces their infants' exposure to secondhand smoke (SHS). METHODS: Participants were 130 nonsmoking children aged less than 1 year, exposed to their fathers' or mothers' smoking, and recruited from a health center in southern Tehran. Eligible families were randomly assigned to intervention or control group. Infant urine samples were collected, and parents were interviewed at baseline and at a 3-month follow-up in each of the 2 groups. Mothers of the intervention group were provided 3 counseling sessions, one of which was face to face and 2 of which were by telephone. Fathers were provided 3 counseling sessions by telephone. Parents were also given an educational pamphlet and a sticker depicting a smoke-free home. The control group received usual care. Changes in infant urinary cotinine levels, parental cigarette consumption in the presence of the child, and home- and car-smoking bans were assessed. RESULTS: The intervention was effective in reducing infant urinary cotinine levels (1-tailed p = .029). There was a greater decrease in the total daily cigarette consumption in the presence of the child in the intervention group compared with the control group, and the differences between the 2 groups were statistically significant (1-tailed p = .03). While the differences between home-smoking bans in the 2 groups were statistically significant (1-tailed p = .049), the differences between car-smoking bans did not reach significance. CONCLUSION: Counseling similar to that employed in other countries can reduce infant exposure to SHS, suggesting generalizability.