Yau Man Ting Kristina, Okoli Chizimuzo T C
Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada.
College of Nursing, University of Kentucky, Lexington, Kentucky, USA.
J Rural Health. 2022 Mar;38(2):364-372. doi: 10.1111/jrh.12611. Epub 2021 Aug 2.
People with psychiatric disorders (PDs) have high risks for tobacco use and associated health effects; however, little is known about differences in tobacco use status and consumption by urban or rural residence. Among patients with PDs, we examined the association of smoke-free policy on tobacco use by rural/urban residence METHOD: A cross-sectional retrospective study (N = 2060) among patients in a psychiatric facility was conducted. Multi-logistic and multilinear regression analyses assessed differences in outcomes stratified by rural/urban status.
Among rural residents, a substance use history (odds ratios [ORs[ = 2.82, 95% CI: 2.01-3.96), high school education (OR = 0.71, 95% CI: 0.51-0.98), older age (OR = 0.99, 95% CI: 0.98-1.00), and longer length of hospital stay (OR = 0.99, 95% CI: 0.98-1.00) were associated with tobacco use. Among urban residents, male sex (OR = 1.38, 95% CI: 1.02-1.86), a substance use history (OR = 2.61, 95% CI: 1.86-3.66), and externalizing disorder diagnosis (OR = 2.72, 95% CI: 1.35-5.48) correlated with tobacco use. Increased tobacco consumption among rural residents was associated with being male (β = 0.12, p = 0.007) and having less than a high school education (β = 0.14, P = 0.001). Whereas, White ethnicity (β = 0.14, p = 0.006), having less than a high school education (β = 0.11, p = 0.022), and a psychotic disorder diagnosis (β = 0.25, p = 0.038) were associated with greater tobacco consumption in urban residents. Smoke-free policy was not associated with tobacco use (OR = 1.08, 95% CI: 0.87-1.34) and consumption (β = 0.05, p = 0.134).
Despite higher rates of tobacco use among rural patients with PDs, they have similar risk factors as their urban counterparts. However, residing in a location with a smoke-free policy may not contribute to tobacco use behaviors among those with PDs.
患有精神疾病（PDs）的人群吸烟风险高且会产生相关健康影响；然而，关于城乡居民吸烟状况和消费量的差异却知之甚少。在患有PDs的患者中，我们研究了无烟政策与城乡居民吸烟情况之间的关联。方法：对一家精神病机构的患者进行了一项横断面回顾性研究（N = 2060）。多逻辑回归和多线性回归分析评估了按城乡状况分层的结果差异。
在农村居民中，有物质使用史（优势比[ORs]=2.82，95%置信区间：2.01 - 3.96）、高中学历（OR = 0.71，95%置信区间：0.51 - 0.98）、年龄较大（OR = 0.99，95%置信区间：0.98 - 1.00）以及住院时间较长（OR = 0.99，95%置信区间：0.98 - 1.00）与吸烟有关。在城市居民中，男性（OR = 1.38，95%置信区间：1.02 - 1.86）、有物质使用史（OR = 2.61，95%置信区间：1.86 - 3.66）以及外向型障碍诊断（OR = 2.72，95%置信区间：1.35 - 5.48）与吸烟相关。农村居民烟草消费量增加与男性（β = 0.12，p = 0.007）和高中以下学历（β = 0.14，P = 0.001）有关。而在城市居民中，白人种族（β = 0.14，p = 0.006）、高中以下学历（β = 0.11，p = 0.022）以及精神病诊断（β = 0.25，p = 0.038）与烟草消费量增加有关。无烟政策与吸烟情况（OR = 1.08，95%置信区间：0.87 - 1.34）和消费量（β = 0.05，p = 0.134）无关。
尽管农村患有PDs的患者吸烟率较高，但他们与城市患者有相似的风险因素。然而，居住在有无烟政策的地区可能不会影响患有PDs人群的吸烟行为。
