Clinical correlates of tobacco use among hospitalized psychiatric patients

Introduction: Recently concluded the National Mental Health Survey found the prevalence of tobacco use disorder to be 20.9% in adults (male = 32.8% and female = 9.8%). The burden of tobacco use disorder is higher in patients with mental illnesses, which significantly affects the treatment outcome. The aim of the study was to estimate the prevalence of tobacco use in psychiatry in-patients of a tertiary care hospital in North India and to compare sociodemographic and clinical parameters between tobacco users and nonusers. Methods: This is a cross-sectional, observational study conducted on psychiatric in-patients of a tertiary care hospital in North India. Retrospective chart review of patients with age ≥ 15 years was done. Data were extracted in a semi-structured pro forma. Comparison of sociodemographic and clinical parameters between tobacco users and nonusers was done using an appropriate statistical tool. Results: The study sample consisted of 303 psychiatric in-patients, of which 121 (39.9%) of patients were tobacco users (males = 58.85% and females = 7.21%). Among tobacco users, 52% were primarily suffering from severe mental disorders, 29% from common mental disorders. Tobacco users had a higher number of psychiatric comorbidities and comorbid other substance use disorders than tobacco nonusers. Comorbid alcohol use (38%) and cannabis use (34%) were also high in the tobacco user group. Those using tobacco were significantly less adherent to treatment.Conclusion: Tobacco use is seen in 2/5th of the psychiatric in-patients. High psychiatric comorbidity and poor treatment adherence are more common among tobacco users.