Tobacco smoking and medical co-morbidities among patients with schizophrenia in a Nigerian clinical setting.

BACKGROUND: Smoking is highly prevalent in patients living with schizophrenia and is associated with medical and psychiatric morbidities

METHODS: In this descriptive, consecutive patients with schizophrenia (368) were interviewed at State Hospital Ibadan between January and December 2008. Information on demography and tobacco smoking, medication adherence and self reports of chronic common health conditions were obtained. The PANSS was used to determine level of psychopathology. Univariate associations were determined using Chi square statistics and multivariate analysis was used for further exploration of variables that were significant during univariate analysis. All analyses were performed using the SPSS (17.0).

RESULTS: Prevalence of lifetime tobacco use was 198 (53.8%), current use 122 (33.1%). Current use was highest in respondents less than 25 years of age X2 = 11.8, p = 0.003 and reduced with increasing education, X2 = 21.6, p = 0.00, higher in non medication adherent patients, X2 = 19.9, p = 0.00 and was associated with health conditions such as haemopoetic diseases X2 = 6.8, p = 0.01 and respiratory diseases. Mean score of positive, negative, general psychopathology, total psychopathology subscales of PANSS were respectively significantly higher among current user, compared with abstainers, t = 6.7, p = 0.00, t = 5.1, p = 0.00, t 6.2, p.= 0.00, t 6.7, p = 0.00. Only general psychopathology subscale of PANSS, OR = 3.5, 95% CI (1.2-6.5), p = 0.02 remained associated with current tobacco use after adjusting for gender.

CONCLUSION: The present study demonstrates high rate of tobacco use in patients with schizophrenia. Thus, such patients require additional screening for tobacco and tobacco cessation program.