Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, RI 02912, USA.
Department of Social Sciences and Health Policy, Wake Forest School of Medicine, Winston-Salem, NC 27127, USA.
Prev Med. 2020 Nov;140:106190. doi: 10.1016/j.ypmed.2020.106190. Epub 2020 Jul 3.
Smokers with serious mental illness (SMI) are less responsive to cessation treatments than those without SMI. In this study, we compared smokers with and without SMI on validated measures of biological and psychosocial factors associated with tobacco use. Smokers with (n = 58) and without SMI (n = 83) who were enrolled in parallel clinical trials were compared on measures of carbon monoxide (CO) exposure, nicotine exposure, tobacco-specific nitrosamine exposure, craving, smoking motives, affect, perceived stress, environmental exposure to smoke/smokers, respiratory symptoms, tobacco-related health risk perceptions, and whether they had received recent advice to quit smoking from a health care provider. Data were collected between 2013 and 2017 in Providence, Rhode Island, USA. Samples were compared using independent-sample t-tests and chi-squared tests. Smokers with SMI had higher CO, nicotine, and tobacco-specific nitrosamine exposure levels, greater cigarette dependence, higher craving, and higher scores on eight out of eleven smoking motives (p's < 0.05). Smokers with SMI reported more severe respiratory symptoms but lower perceived health risks of tobacco (p's < 0.05). These smokers were more likely to report having received advice to quit from a medical provider in the past 6 weeks (p < 0.05). Affect, stress, and exposure to smoke/smokers did not differ across samples. Our findings advance the understanding of the elevated smoking rates of people with SMI by comparing smokers with and without SMI on validated biopsychosocial measures. There is a need for interventions that reduce craving, reduce smoking motives, and increase risk awareness among smokers with SMI.
患有严重精神疾病（SMI）的吸烟者对戒烟治疗的反应不如没有 SMI 的吸烟者。在这项研究中，我们比较了患有和不患有 SMI 的吸烟者在与烟草使用相关的经验证的生物和社会心理因素测量上的差异。患有 SMI（n=58）和不患有 SMI（n=83）的吸烟者平行参与了临床试验，我们比较了他们的一氧化碳（CO）暴露、尼古丁暴露、烟草特异性亚硝胺暴露、渴望程度、吸烟动机、情绪、感知压力、环境吸烟/吸烟者暴露、呼吸症状、与烟草相关的健康风险感知，以及他们最近是否从医疗保健提供者那里获得戒烟建议。数据收集于 2013 年至 2017 年在美国罗德岛州普罗维登斯市进行。样本使用独立样本 t 检验和卡方检验进行比较。患有 SMI 的吸烟者 CO、尼古丁和烟草特异性亚硝胺暴露水平更高，烟瘾更大，渴望程度更高，11 个吸烟动机中有 8 个得分更高（p<0.05）。患有 SMI 的吸烟者报告呼吸症状更严重，但对烟草的健康风险认知较低（p<0.05）。这些吸烟者更有可能在过去 6 周内从医疗提供者那里获得戒烟建议（p<0.05）。情感、压力和暴露于烟雾/吸烟者在样本之间没有差异。我们的研究通过在经验证的生物心理社会测量上比较患有和不患有 SMI 的吸烟者，推进了对患有 SMI 的人吸烟率升高的理解。需要针对患有 SMI 的吸烟者的干预措施，以减少渴望、减少吸烟动机和提高风险意识。
