Background
Methods
Setting
Study design
Population
Data collection
Classification of psychiatric disorders
Classification of psychotropic medications
Statistical analysis
Results
Prevalence of current smoking
Demographic characteristics and smoking
Overall (N = 1193) | Current smoking in males (N = 624) | Current smoking in females (N = 569) | |||||
---|---|---|---|---|---|---|---|
No (N = 260) | Yes (N = 364) | p value | No (N = 531) | Yes (N = 38) | p value | ||
Age (years) | |||||||
Mean ± SD | 38.0 ± 13.0 | 37.1 ± 14.0 | 37.8 ± 11.2 | 0.516 | 38.7 ± 13.8 | 36.5 ± 9.9 | 0.331 |
< 40 | 708 (59.6%) | 163 (41.5%) | 230 (58.5%) | 0.081 | 293 (93.0%) | 22 (7.0%) | 0.329 |
40–60 | 420 (35.4%) | 76 (38.4%) | 122 (61.6%) | 207 (93.2%) | 15 (6.8%) | ||
> 60 | 60 (5.1%) | 18 (60.0%) | 12 (40.0%) | 30 (100.0%) | 0 (0.0%) | ||
Marital status | |||||||
Married | 524 (45.7%) | 107 (49.8%) | 108 (50.2%) | < 0.001 | 293 (94.8%) | 16 (5.2%) | 0.359 |
Single | 504 (44.0%) | 125 (37.5%) | 208 (62.5%) | 157 (91.8%) | 14 (8.2%) | ||
Divorced | 106 (9.2%) | 8 (19.0%) | 34 (81.0%) | 58 (90.6%) | 6 (9.4%) | ||
Widowed | 12 (1.0%) | 0 (0.0%) | 0 (0.0%) | 12 (100.0%) | 0 (0.0%) | ||
Number of children | 3.5 ± 3.2 | 3.9 ± 3.6 | 3.3 ± 2.9 | 0.180 | 3.5 ± 3.2 | 2.9 ± 3.1 | 0.374 |
Educational level | |||||||
Illiterate | 251 (21.5%) | 45 (55.6%) | 36 (44.4%) | < 0.001 | 165 (97.1%) | 5 (2.9%) | 0.010 |
Secondary or less | 766 (65.6%) | 161 (35.8%) | 289 (64.2%) | 287 (90.8%) | 29 (9.2%) | ||
University/other | 151 (12.9%) | 46 (61.3%) | 29 (38.7%) | 74 (97.4%) | 2 (2.6%) | ||
Working status | |||||||
Not working | 832 (71.2%) | 151 (42.5%) | 204 (57.5%) | 0.492 | 450 (94.3%) | 27 (5.7%) | 0.301 |
Working | 336 (28.8%) | 103 (39.8%) | 156 (60.2%) | 70 (90.9%) | 7 (9.1%) | ||
Family income (SR) | |||||||
≤ 3000 | 344 (29.8%) | 73 (38.2%) | 118 (61.8%) | 0.009 | 143 (93.5%) | 10 (6.5%) | 0.695 |
3001–6000 | 372 (32.2%) | 72 (35.5%) | 131 (64.5%) | 161 (95.3%) | 8 (4.7%) | ||
6001–9000 | 241 (20.8%) | 53 (44.2%) | 67 (55.8%) | 112 (92.6%) | 9 (7.4%) | ||
> 9000 | 199 (17.2%) | 48 (55.8%) | 38 (44.2%) | 104 (92.0%) | 9 (8.0%) | ||
Residential type | |||||||
City | 955 (80.4%) | 225 (43.1%) | 297 (56.9%) | 0.004 | 403 (93.1%) | 30 (6.9%) | 0.411 |
Village | 206 (17.3%) | 29 (30.9%) | 65 (69.1%) | 106 (94.6%) | 6 (5.4%) | ||
Desert | 27 (2.3%) | 6 (85.7%) | 1 (14.3%) | 20 (100.0%) | 0 (0.0%) | ||
Body mass index (BMI) | |||||||
Mean ± SD | 28.7 ± 7.7 | 28.4 ± 6.5 | 27.4 ± 7.1 | 0.096 | 29.8 ± 8.4 | 29.3 ± 8.2 | 0.738 |
Non-obese | 719 (62.1%) | 161 (38.0%) | 263 (62.0%) | 0.010 | 273 (92.5%) | 22 (7.5%) | 0.218 |
Obese | 438 (37.9%) | 94 (49.0%) | 98 (51.0%) | 234 (95.1%) | 12 (4.9%) | ||
Physical activity | |||||||
Active | 149 (12.7%) | 40 (42.1%) | 55 (57.9%) | 0.920 | 46 (85.2%) | 8 (14.8%) | 0.017 |
Not active | 1028 (87.3%) | 214 (41.6%) | 301 (58.4%) | 484 (94.3%) | 29 (5.7%) |
Clinical characteristics and smoking
Overall (N = 1193) | Current smoking in males (N = 624) | Current smoking in females (N = 569) | |||||
---|---|---|---|---|---|---|---|
No (N = 260) | Yes (N = 364) | p value | No (N = 260) | Yes (N = 364) | p value | ||
Hospitalization status | |||||||
Inpatient | 394 (33.0%) | 78 (33.1%) | 158 (66.9%) | 0.001 | 142 (89.9%) | 16 (10.1%) | 0.041 |
Outpatient | 799 (67.0%) | 182 (46.9%) | 206 (53.1%) | 389 (94.6%) | 22 (5.4%) | ||
Age at disease onset | |||||||
Mean ± SD | 28.3 ± 12.0 | 27.4 ± 12.1 | 28.1 ± 10.0 | 0.466 | 29.2 ± 13.2 | 24.6 ± 9.6 | 0.039 |
< 25 years | 487 (41.6%) | 120 (46.3%) | 139 (53.7%) | 0.059 | 209 (91.7%) | 19 (8.3%) | 0.179 |
≥ 25 years | 684 (58.4%) | 137 (38.7%) | 217 (61.3%) | 312 (94.5%) | 18 (5.5%) | ||
Disease duration | |||||||
Mean ± SD | 9.7 ± 9.3 | 9.7 ± 9.6 | 9.6 ± 8.0 | 0.872 | 9.5 ± 10.0 | 11.9 ± 10.5 | 0.161 |
≤ 10 years | 781 (66.8%) | 175 (42.5%) | 237 (57.5%) | 0.593 | 349 (94.6%) | 20 (5.4%) | 0.108 |
> 10 years | 388 (33.2%) | 80 (40.2%) | 119 (59.8%) | 172 (91.0%) | 17 (9.0%) | ||
Previous psychiatric hospitalization | |||||||
No | 644 (54.0%) | 151 (49.2%) | 156 (50.8%) | < 0.001 | 323 (95.8%) | 14 (4.2%) | 0.004 |
Yes | 549 (46.0%) | 109 (34.4%) | 208 (65.6%) | 208 (89.7%) | 24 (10.3%) | ||
Mean ± SD | 3.8 ± 4.4 | 2.8 ± 3.3 | 4.1 ± 5.1 | 0.019 | 4.0 ± 4.0 | 3.7 ± 4.0 | 0.704 |
Medical history | |||||||
Diabetes mellitus | 113 (9.5%) | 26 (47.3%) | 29 (52.7%) | 0.377 | 56 (96.6%) | 2 (3.4%) | 0.411 |
Hypertension | 92 (7.7%) | 16 (30.2%) | 37 (69.8%) | 0.076 | 37 (94.9%) | 2 (5.1%) | > 0.95 |
Hyperthyroidism | 25 (2.1%) | 1 (50.0%) | 1 (50.0%) | > 0.95 | 22 (95.7%) | 1 (4.3%) | > 0.95 |
Hypothyroidism | 39 (3.3%) | 4 (100.0%) | 0 (0.0%) | 0.029 | 34 (97.1%) | 1 (2.9%) | 0.714 |
Cerebrovascular accident | 14 (1.2%) | 3 (50.0%) | 3 (50.0%) | 0.697 | 7 (87.5%) | 1 (12.5%) | 0.427 |
Hyperlipidemia | 12 (1.0%) | 3 (33.3%) | 6 (66.7%) | 0.742 | 3 (100.0%) | 0 (0.0%) | > 0.95 |
Epilepsy | 12 (1.0%) | 4 (66.7%) | 2 (33.3%) | 0.241 | 5 (83.3%) | 1 (16.7%) | 0.341 |
Kidney disease | 10 (0.9%) | 5 (100.0%) | 0 (0.0%) | 0.012 | 5 (100.0%) | 0 (0.0%) | > 0.95 |
Asthma | 8 (0.7%) | 4 (66.7%) | 2 (33.3%) | 0.241 | 2 (100.0%) | 0 (0.0%) | > 0.95 |
Substance abuse | 273 (24.4%) | 52 (21.3%) | 192 (78.7%) | < 0.001 | 22 (75.9%) | 7 (24.1%) | < 0.001 |
Medication use | |||||||
Diabetes | 83 (7.0%) | 19 (45.2%) | 23 (54.8%) | 0.627 | 39 (95.1%) | 2 (4.9%) | > 0.95 |
Hypertension | 44 (3.7%) | 12 (40.0%) | 18 (60.0%) | 0.849 | 14 (100.0%) | 0 (0.0%) | 0.614 |
Hyperlipidemia | 19 (1.6%) | 6 (46.2%) | 7 (53.8%) | 0.740 | 6 (100.0%) | 0 (0.0%) | > 0.95 |
Psychiatric disorders/medications and smoking
Overall (N = 1193) | Current smoking in males (N = 624) | Current smoking in females (N = 569) | |||||
---|---|---|---|---|---|---|---|
No (N = 260) | Yes (N = 364) | p value | No (N = 260) | Yes (N = 364) | p value | ||
Number of psychiatric disorders | |||||||
One | 1079 (90.4%) | 233 (41.5%) | 329 (58.5%) | 0.751 | 481 (93.0%) | 36 (7.0%) | 0.391 |
Two or more | 114 (9.6%) | 27 (43.5%) | 35 (56.5%) | 50 (96.2%) | 2 (3.8%) | ||
Psychiatric disorders | |||||||
Primary psychotic disorders | 491 (41.2%) | 119 (36.3%) | 209 (63.7%) | 0.004 | 143 (87.7%) | 20 (12.3%) | 0.001 |
Primary bipolar disorders | 183 (15.3%) | 29 (41.4%) | 41 (58.6%) | 0.966 | 106 (93.8%) | 7 (6.2%) | 0.818 |
Primary depressive disorders | 200 (16.8%) | 37 (59.7%) | 25 (40.3%) | 0.002 | 132 (95.7%) | 6 (4.3%) | 0.208 |
Primary anxiety disorders | 131 (11.0%) | 32 (54.2%) | 27 (45.8%) | 0.040 | 72 (100.0%) | 0 (0.0%) | 0.009 |
Personality disorders | 18 (1.5%) | 1 (12.5%) | 7 (87.5%) | 0.148 | 10 (100.0%) | 0 (0.0%) | > 0.95 |
Secondary psychiatric disorders | 44 (3.7%) | 12 (33.3%) | 24 (66.7%) | 0.296 | 5 (62.5%) | 3 (37.5%) | 0.012 |
Multiple disorders | 80 (6.7%) | 15 (35.7%) | 27 (64.3%) | 0.418 | 36 (94.7%) | 2 (5.3%) | > 0.95 |
Other disorders | 46 (3.9%) | 15 (78.9%) | 4 (21.1%) | 0.001 | 27 (100.0%) | 0 (0.0%) | 0.245 |
Number of psychotropic medications | |||||||
One | 363 (33.5%) | 97 (47.8%) | 106 (52.2%) | 0.004 | 148 (92.5%) | 12 (7.5%) | 0.497 |
Two or more | 719 (66.5%) | 129 (35.4%) | 235 (64.6%) | 334 (94.1%) | 21 (5.9%) | ||
Psychotropic medications | |||||||
Any antipsychotic | 830 (76.7%) | 164 (35.9%) | 293 (64.1%) | < 0.001 | 342 (91.7%) | 31 (8.3%) | 0.004 |
First generation, low potency | 59 (5.5%) | 11 (42.3%) | 15 (57.7%) | 0.794 | 32 (97.0%) | 1 (3.0%) | 0.713 |
First generation, high potency | 177 (16.4%) | 44 (41.9%) | 61 (58.1%) | 0.635 | 66 (91.7%) | 6 (8.3%) | 0.440 |
Second generation | 733 (67.7%) | 147 (35.7%) | 265 (64.3%) | 0.001 | 292 (91.0%) | 29 (9.0%) | 0.002 |
Any antidepressant | 450 (41.6%) | 93 (46.3%) | 108 (53.7%) | 0.021 | 240 (96.4%) | 9 (3.6%) | 0.012 |
SSRI antidepressants | 312 (28.8%) | 63 (50.4%) | 62 (49.6%) | 0.006 | 180 (96.3%) | 7 (3.7%) | 0.062 |
Tricyclic antidepressants | 69 (6.4%) | 10 (47.6%) | 11 (52.4%) | 0.459 | 45 (93.8%) | 3 (6.3%) | > 0.95 |
Other antidepressants | 158 (14.6%) | 28 (32.6%) | 58 (67.4%) | 0.133 | 70 (97.2%) | 2 (2.8%) | 0.133 |
Mood stabilizers | 301 (27.8%) | 59 (38.6%) | 94 (61.4%) | 0.701 | 140 (94.6%) | 8 (5.4%) | 0.555 |
Antianxiety | 68 (6.3%) | 8 (29.6%) | 19 (70.4%) | 0.266 | 39 (95.1%) | 2 (4.9%) | > 0.95 |
Independent associations of smoking
Current smoking in males (N = 543) | Current smoking in females (N = 505) | |||||
---|---|---|---|---|---|---|
Odds ratio | 95% confidence interval | p value | Odds ratio | 95% confidence interval | p value | |
Full adjustmenta plus disorders | ||||||
Education (educated) |
1.82
|
1.03–3.23
|
0.040
| |||
Family income (< 6000 SR) |
1.90
|
1.26–2.86
|
0.002
| |||
BMI (non-obese) | 1.49 | 1.00–2.22 | 0.053 | |||
Hospitalization status (inpatient) |
1.72
|
1.16–2.56
|
0.007
| |||
Substance abuse |
5.28
|
3.52–7.93
|
< 0.001
|
10.56
|
3.78–29.53
|
< 0.001
|
Primary psychotic disorders |
3.47
|
1.45–8.27
|
0.005
| |||
Full adjustmenta plus medications | ||||||
Education (educated) | 3.09 | 0.90–10.55 | 0.072 | |||
Marital status (unmarried) | 1.44 | 0.94–2.20 | 0.092 | |||
Family income (< 6000 SR) |
1.58
|
1.04–2.39
|
0.032
| |||
Hospitalization status (inpatient) | 2.38 | 0.91–6.20 | 0.077 | |||
Age at disease onset (≥ 25 years) |
2.94
|
1.00–8.46
|
0.049
| |||
Substance abuse |
5.18
|
3.39–7.92
|
< 0.001
|
14.15
|
4.32–46.35
|
< 0.001
|
Antipsychotic medications |
1.79
|
1.10–2.93
|
0.020
| 4.68 | 0.95–22.95 | 0.057 |