1Discipline of Psychiatry, School of Medicine, The University of Adelaide, Adelaide, Australia.
Aust N Z J Psychiatry. 2014 Jan;48(1):70-9. doi: 10.1177/0004867413491158. Epub 2013 Jun 5.
This study aimed to identify factors associated with the high rates of smoking amongst people with psychosis living in a disadvantaged region in Adelaide, South Australia.
Data were collected from 402 people with psychosis, aged 18-64 years, who lived in the northern suburbs of Adelaide. This area is disadvantaged on many measures of socioeconomic well-being and people living in this region have higher rates of smoking compared to the general Australian population. We hypothesised that whilst tobacco use by people with psychosis living in this region was primarily associated with mental illness, factors related to social disadvantage also contributed to the high rates of smoking.
Approximately 74% of men and 71% of women with psychotic disorders living in the northern suburbs of Adelaide were current smokers. Factors such as unemployment, lower levels of education and receiving government welfare, factors known to be associated with smoking in the general population, were more prevalent in the northern region. Smokers with psychosis were less likely to participate in recreational programs and physical activity, and more likely to use illicit substances and be a victim of crime. They had poorer health and financial outcomes than non-smokers. There were some gender differences: for men with psychosis, employment and having a post-school qualification decreased the risk of smoking while cannabis use increased the risk; for women with psychosis, a diagnosis of alcohol abuse/dependence, using cannabis and being sedentary were risk factors for smoking, while attending recreational programs reduced this risk.
Smoking rates were strikingly high in both men and women, and particularly high in women when compared with previous research. Our study shows that the risk of smoking is increased by factors related to the social disadvantage of living in the northern Adelaide region. Smoking cessation interventions for people with mental illness should take into account the social context, and also address relevant comorbidities such as drug and alcohol disorders.
本研究旨在确定与南澳大利亚阿德莱德一个弱势地区的精神病患者吸烟率高相关的因素。
数据来自 402 名年龄在 18-64 岁之间的精神病患者，他们居住在阿德莱德北部郊区。该地区在社会经济福祉的许多方面都处于不利地位，居住在该地区的人们的吸烟率高于澳大利亚一般人群。我们假设，尽管该地区精神病患者的吸烟主要与精神疾病有关，但与社会劣势相关的因素也促成了高吸烟率。
阿德莱德北部郊区约 74%的男性和 71%的女性精神障碍患者是当前吸烟者。失业、教育程度较低和接受政府福利等因素在北部地区更为普遍，这些因素与普通人群中的吸烟有关。患有精神病的吸烟者较少参加娱乐活动和体育锻炼，更有可能使用非法药物和成为犯罪受害者。他们的健康和财务状况比不吸烟者差。存在一些性别差异：对于男性精神病患者，就业和具有中学后学历降低了吸烟的风险，而大麻使用则增加了风险；对于女性精神病患者，酒精滥用/依赖、使用大麻和久坐不动的诊断是吸烟的危险因素，而参加娱乐活动则降低了这种风险。
无论是男性还是女性，吸烟率都非常高，与之前的研究相比，女性的吸烟率尤其高。我们的研究表明，与居住在阿德莱德北部地区的社会劣势相关的因素增加了吸烟的风险。针对精神疾病患者的戒烟干预措施应考虑到社会背景，并解决相关的合并症，如药物和酒精障碍。
