Predictors of tobacco use among persons with mental illnesses in a statewide population
ABSTRACT This study used statewide administrative data sets to estimate the prevalence of tobacco use among persons with mental illnesses who were accessing public-sector mental health care in Colorado and to determine the relationships between tobacco use and primary diagnosis and alcohol and drug use.
This study utilized the Colorado Client Assessment Record to examine predictors of tobacco use among 111,984 persons with mental illnesses who were receiving services in the public mental health system.
Thirty-nine percent of the sample (N=43,508) used tobacco. Multiple logistic regression analysis found that schizophrenia, schizoaffective disorder, and bipolar disorder (p<.001 for all), and depression or dysthymia (p<.01) were associated with greater tobacco use than other diagnoses. Significant differences in tobacco use existed across gender, age group, race or ethnicity, and substance use categories.
Findings suggest that an administrative database is a low-burden means of identifying persons at high risk of tobacco use to inform resource allocation.
Full-textDOI: · Available from: Miriam Dickinson, Jul 08, 2015
- SourceAvailable from: bhwellness.org
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- "There is also a correlation between parental smoking and age of onset of youth smoking, whereby parent smoking increases the risk of early onset smoking by their children (Wang et al., 1998). This is particularly concerning for youth with mental illnesses, given the high prevalence of smoking among adults with mental health disorders and the genetic risk of mental illness (Morris et al., 2006; Smoller & Finn, 2003; Sullivan et al., 2000; Sullivan, 2005). Intervention programs targeting parents may assist in overcoming this barrier. "
ABSTRACT: Despite an abundance of literature documenting the prevalence and dangers of youth tobacco use, there is a relative dearth of literature in the area of effective cessation treatments for youth (Fiore et al. in Clinical tobacco guideline: treating tobacco use and dependence, 2008). Additionally, although it has been widely accepted that mental illness is highly correlated with tobacco use and dependence, little research has been done to support prevention and cessation efforts for youth with mental illnesses. This paper summarizes the literature on tobacco use and cessation in youth, with a focus on describing the existing knowledge base for youth with mental illnesses.Journal of Behavioral Medicine 04/2011; 35(2):139-48. DOI:10.1007/s10865-011-9336-6 · 3.10 Impact Factor
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- "Beside tobacco-induced physical dependence, most smokers report that key motives for smoking include alleviation of negative moods such as anxiety, sadness, and stress (Spielberger and Jacobs 1982; Shiffman 1993). There is considerable evidence that smoking is more prevalent in depressed people (46%) and people with major anxiety disorders than in the general population (26%; Lasser et al. 2000; Morris et al. 2006). The link between psychiatric disorders and tobacco smoking seems even stronger in adolescents as young adults are at high risk for vulnerability to both serious mental illness and cigarette smoking (Laviola et al. 2003; Breslau et al. 2004; Slawecki et al. 2005; Snyder 2006). "
ABSTRACT: Epidemiological studies have demonstrated a comorbidity of smoking with depression and anxiety, particularly during adolescence. However, few animal studies have considered possible synergistic interactions between nicotine and other tobacco smoke constituents, such as monoamine oxidase (MAO) inhibitors, in the regulation of mood. The aim of the study was to test the hypothesis that nicotine combined with the irreversible MAO inhibitor, tranylcypromine, will differentially affect depression- and anxiety-related behaviors in adolescent and adult rats. Nicotine (0, 0.05, 0.2 mg/kg, s.c.) and tranylcypromine (3 mg/kg, i.p.) were tested separately, or together, on male rats aged postnatal days 30 and 68, in three mood-related behavioral tests: forced swim test (FST), elevated plus maze (EPM), and open field. Nicotine (0.2 mg/kg) in adults significantly decreased floating time in the FST and increased time spent in the open arm of the EPM, with no change in locomotor activity. Tranylcypromine pretreatment combined with nicotine (0.2 mg/kg) significantly increased locomotor activity and time spent in the center of the open field. Whereas nicotine alone had no significant effect on adolescents, it significantly increased locomotor activity and decreased floating time in the FST when combined with tranylcypromine pretreatment. There is an age-dependent effect of nicotine, alone and in combination with MAO inhibition, on mood-related behaviors. Whereas nicotine alone induces mood improvement in adults, it has no effect on adolescents. Nicotine combined with tranylcypromine has unique, age-dependent effects. Thus, experimental studies of smoking should consider both age and other tobacco constituents, such as MAO inhibitors, as critical factors.Psychopharmacology 03/2010; 208(4):593-601. DOI:10.1007/s00213-009-1760-8 · 3.99 Impact Factor
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- "Substance abuse is a common feature of bipolar I and schizoaffective disorders, complicating patient management as well as reducing remission rates and quality of life (Mitchell et al., 2007). BCOS study participants had a higher incidence of tobacco use, cannabis use and other illicit drug use compared with the general population, which has also been observed in other studies (Mitchell et al., 2007; Morris et al., 2006). It is not known whether substance abuse among people with these conditions occurs as a means of selfmedication , sensation seeking, or as a result of the disorders' characteristic lack of insight (Maremmani et al., 2006). "
ABSTRACT: The Bipolar Comprehensive Outcomes Study (BCOS) is a 2-year, observational study of participants with bipolar I or schizoaffective disorder examining clinical, functional, and economic outcomes associated with naturalistic treatment. Participants prescribed mood stabilisers were assessed using various measures, including the Young Mania Rating Scale (YMRS), 21-item Hamilton Depression Rating scale (HAMD21), Clinical Global Impressions-Bipolar Version Severity of Illness scale (CGI-BP), and the EuroQol instrument (EQ-5D). 240 participants were recruited from two sites. On average, participants were 41.8+/-12.7 years of age (mean+/-SD), 58.3% were female, and 73.3% had a diagnosis of bipolar I disorder at study entry. The majority of participants were moderately ill, with an average CGI-BP Overall score of 3.8+/-1.3. Most participants had subthreshold mania and depression symptoms, indicated by HAMD21 Total 13.4+/-8.6, CGI-BP Depression 3.2+/-1.3, YMRS Total 8.2+/-8.5 and CGI-BP Mania 3.0+/-1.6 average scores. For bipolar participants, 94.6% of hospitalisations for psychiatric treatment in the past 3 months were single admissions (vs. 65.2% for schizoaffective participants, p=.002). Bipolar participants rated their overall health state higher (EQ-5D scores: 68.2+/-18.8 vs. 61.6+/-22.7, p=.023), had a higher mean weekly wage ($500-$999, 21.3% vs. 6.3%), lower unemployment (22.2% vs. 48.4%), and higher romantic relationship status (47.1% vs. 26.6%). The observational design and small sample size may have limited the causal relationships and generalisability within the current findings. Participants were characterised by social and occupational dysfunction at entry, but schizoaffective participants appeared to be more severely affected. Effective treatment is required to address both clinical and functional impairment.Journal of Affective Disorders 05/2008; 107(1-3):135-44. DOI:10.1016/j.jad.2007.08.012 · 3.71 Impact Factor