Cruvinel Erica, Liebman Edward, Leite Isabel, Hu Jinxiang, Richter Kimber P
Department of Population Health, University of Kansas Medical Center, Kansas City, Kansas, USA
Department of Population Health, University of Kansas Medical Center, Kansas City, Kansas, USA.
BMJ Open. 2020 May 26;10(5):e033959. doi: 10.1136/bmjopen-2019-033959.
Determine the national prevalence of smoking and factors related to smoking among adults with mental illness (PLWMI; people living with mental illness) in Brazil.
Cross-sectional study.
We used data from the nationally representative general health survey of 2013, which included the Global Adult Tobacco Survey (GATS) module.
The survey used a complex probabilistic sample to collect data from 60 202 Brazilians 18 years or older. Primary and secondary outcomes: smoking prevalence and access to smoking cessation treatment. We also assessed past tobacco use, quit attempts and quit ratio among people with and without mental illness. Analyses were conducted in R and were weighted to account for the survey design and generate national estimates.
In Brazil, the 2013 smoking prevalence among PLWMI was 28.4% and among people with no mental illness was 12.8%. Both groups had high rates of past-year quit attempts (51.6% vs 55.3%) but the lifetime quit ratio among PLWMI was much lower than those with no mental illness (37% vs 54%). Adjusted odds showed PLWMI were more likely to be current smokers (OR (95% CI)=2.60 (2.40 to 2.82), less likely to be former smokers (OR (95% CI)=0.62 (0.55 to 0.70)) and as likely to have tried to quit in the past year (OR (95% CI)=0.90 (0.78 to 1.02)). Very few (3.7%) PLWMI and fewer with no mental illness (2.6%) received cessation treatment.
Smoking rates among PLWMI are roughly double the rate in the general population. Compared with Brazilian smokers without mental illness, those with mental illness were significantly less likely to quit even though as many tried to. Few Brazilians appear to be using publicly available cessation services. Expanding utilisation of treatment might be a good place to start for Brazil to further decrease the prevalence of smoking among PLWMI.
确定巴西成年精神疾病患者（PLWMI；患有精神疾病的人）的全国吸烟率及与吸烟相关的因素。
横断面研究。
我们使用了2013年具有全国代表性的一般健康调查数据，其中包括全球成人烟草调查（GATS）模块。
该调查采用复杂概率样本，从60202名18岁及以上的巴西人中收集数据。主要和次要结果：吸烟率及获得戒烟治疗的情况。我们还评估了有精神疾病和无精神疾病人群过去的烟草使用情况、戒烟尝试及戒烟成功率。分析在R软件中进行，并进行加权以考虑调查设计并生成全国估计值。
在巴西，2013年PLWMI的吸烟率为28.4%，无精神疾病者的吸烟率为12.8%。两组过去一年的戒烟尝试率都很高（分别为51.6%和55.3%），但PLWMI的终生戒烟成功率远低于无精神疾病者（分别为37%和54%）。调整后的优势比显示，PLWMI更有可能是当前吸烟者（OR（95%CI）=2.60（2.40至2.82）），不太可能是既往吸烟者（OR（95%CI）=0.62（0.55至0.70）），且过去一年尝试戒烟的可能性相同（OR（95%CI）=0.90（0.78至1.02））。极少有PLWMI（3.7%）和更少的无精神疾病者（2.6%）接受了戒烟治疗。
PLWMI的吸烟率约为普通人群的两倍。与无精神疾病的巴西吸烟者相比，有精神疾病的吸烟者即使尝试戒烟，成功戒烟的可能性也显著更低。很少有巴西人似乎在使用公共可用的戒烟服务。扩大治疗的利用率可能是巴西进一步降低PLWMI吸烟率的一个良好起点。
