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Table of Contents
ORIGINAL ARTICLE
Year : 2018  |  Volume : 15  |  Issue : 1  |  Page : 39-42

Knowledge regarding adverse effects of tobacco smoking among the schizophrenia patients


1 Nursing Tutor, Department of Psychiatric Nursing, LGBRIMH, Tezpur, Assam, India
2 Prof & HOD, Department of Psychiatric Nursing, LGBRIMH, Tezpur, Assam, India
3 Nursing officer, Department of Psychiatric Nursing, LGBRIMH, Tezpur, Assam, India

Date of Web Publication10-Jul-2019

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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/2231-1505.262504

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  Abstract 


Heavier tobacco smoking pattern, in spite of its detrimental consequences is common among the schizophrenia patients in India as it is in the rest of world. But very limited studies have been conducted in north-east of India to find the knowledge level among the schizophrenia patients regarding the adverse effects of tobacco smoking, which is again limited in rest of India and outside India. Therefore, the study was conducted with the aim of assessing the knowledge regarding adverse effects of tobacco smoking among the schizophrenia patients. Materials and methods: A descriptive research design was adopted to conduct the study at the out-patient department of LGBRIMH, Tezpur. A sample of 30 schizophrenia patients diagnosed as per ICD-10 criteria, were selected by using a purposive sampling technique. The data was collected by using a self-structured questionnaire and was analyzed by descriptive and inferential statistics. Results: Findings revealed that among the schizophrenia patients, majority (80.0%, n=24) were having an increased knowledge score regarding the adverse effects of smoking and there was a significant association present (χ2=5.000, P=0.025) between the knowledge score and the level of education of the participants. Conclusion: The study results shows that motivation enhancement among the schizophrenia patients will be very important for their self motivated involvement for the avoidance of this negative health related behaviour which has some detrimental adverse effects particularly on their present health condition.

Keywords: Smoking, Adverse effects of smoking, Schizophrenia


How to cite this article:
Sarkar S, Baruah A, Nath B. Knowledge regarding adverse effects of tobacco smoking among the schizophrenia patients. Indian J Psy Nsg 2018;15:39-42

How to cite this URL:
Sarkar S, Baruah A, Nath B. Knowledge regarding adverse effects of tobacco smoking among the schizophrenia patients. Indian J Psy Nsg [serial online] 2018 [cited 2022 Oct 6];15:39-42. Available from: https://www.ijpn.in/text.asp?2018/15/1/39/262504




  Background Top


Tobacco is an agricultural crop containing nicotine and is used in many forms including smoked and smokeless forms in all over the world. Tobacco smoking though practiced in various forms in India, the main forms practiced here are, cigarette, bidi and hookah. Tobacco smoking in any form is linked with the negative consequences to person’s physical, mental and social health, as well as the economy. In India, tobacco use, and in particular smoking, is the largest cause of preventable death among adults, as it is globallyl But in spite of its detrimental consequences, it is common throughout the world due to a variety of reasons and many people indulge in this negative health behaviour every day. However, it has been recognized that persons with mental illness have heavier smoking pattern when compared with general population and patients with other physical disorders; where prevalence of smoking among schizophrenia patients is higher as compared to patients with other mental illnesses2. A study on cigarette smoking and schizophrenia shows that only 8% of male patients with schizophrenia were ex-smokers, compared with 31% of males in a local general population, which indicates that rate of quitting among the mentally ill is less compared to general population suggesting an excess of smoking among these groups3.According to multiple studies[4],[5], reports and clinical observations, the causes of increased tobacco smoking among the persons with mental illness are based on some biological, psychological and social factors. Persons with mental illnesses have unique neurobiological features that may increase their tendency to use nicotine. Nicotine affects the actions of neurotransmitters like dopamine. For example, people with schizophrenia who use tobacco may experience less negative symptoms (lack of motivation, drive and energy). Again nicotine temporarily enhances concentration, information processing and learning, which is especially important for persons with psychotic disorders for whom cognitive dysfunction may be a part of their illness or a side effect of antipsychotic medications. Other biological factors include nicotine’s positive adverse effects on mood, feelings of pleasure and enjoyment. The Psychological factors in this concern are: tobacco use may temporarily relieve feelings of tension and anxiety and is often used to cope with stress. The social factors again may be feeling “part of a group” while smoking. Many times Schizophrenia patients do not have a lot of activities to keep them busy. So, when they’re bored, they may smoke more[6],[7]. But very limited studies have been conducted in north-east of India to find out the knowledge level among the schizophrenia patients regarding the adverse effects of smoking, which is again very limited in rest of India and outside India.


  Martial and methods Top


A descriptive research design was adopted to conduct the study. The objectives was to assess the socio-demographic and clinical variables, to assess the knowledge about the adverse effects of tobacco smoking among the Schizophrenia patients and to find out the association of knowledge with the selected socio-demographic and clinical variables. The study setting was the out patient department of LGBRIMH, Tezpur. A sample of 30 Schizophrenia patients(ICD-10), were selected by purposive sampling technique, patients with psychotic features were excluded from the study. The data was collected by using a structured questionnaire after obtaining a written consent from the participants. Data was analyzed by descriptive and inferential statistics.


  Results Top


As given in [Table 1], that all the participants were male (100%, n=30). Among the participants majority were Hindu (73.3%, n=22), aged between 18 to 23 years (53.3%, n=16), cultivator (30.0%, n=9) with a total family income of Rs 5000- Rs 10000/month (33.3%, n=10) and educated till secondary level (46.7%, n=14).The table also showed that, majority of the participants had a duration of illness of 0-5 years (66.7%, 20) were smoking twice a day (36.7%, n=22) in the form of both bidi and cigarette (46.7%, n=14) with an expenditure of Rs <10 per day (63.3%, n=19). Most of them had their last intake within <3 months (46.7%, n=14).
Table 1: Frequency and percentage distribution of socio-demographic and clinical variables among the Patients having Schizophrenia n=30

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As given in [Table 2] that the knowledge score regarding adverse effects of tobacco smoking among the Schizophrenia patients ranged from 7.00 to 23.00, with a mean score of 15.0000 and SD of4.11054.
Table 2: Range, mean and standard deviation of knowledge score regarding adverse effects of smoking among the Patients having Schizophrenia

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As given in [Table 3] that among the Schizophrenia patients, majority i.e. 80.0% (n=24) were having knowledge regarding the adverse effects of smoking between the score of 12–23 and the rest i.e. 20.0% (n=6) were having the knowledge between the score of 0-11.
Table 3: Frequency and percentage distribution of knowledge score regarding adverse effects of smoking among the Patients having Schizophrenia. n=30

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As depicted in [Table 4] that all the participants had responded that their source of information regarding the effects of smoking were from more than one source; where, majority (n=29, 96.66 %) of them got information regarding adverse effects of smoking from media messages, whereas 23 (76.66 %) got from their family members, 20 (66.66 %) got from health personals, 15 (50.00 %) of them from their friends and rest 10 (33.33 %) of them got the information from the shop keepers who sells tobacco products.
Table 4: Frequency and percentage distribution of sources of information among the Patients having Schizophrenia n=30

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As shown in [Table 5] that there is no significant association present between the knowledge score of the Schizophrenia patients with selected socio-demographic variables like, age, religion, income, occupation, duration of illness, type of tobacco smoked, frequency of smoking per day and expenditure on smoking and the last intake; but a significant association is present (χ2= 5.000, P= 0.025) between the knowledge score of the Schizophrenia patients with education.
Table 5: Association between knowledge with selected the socio demographic variables among the Patients having Schizophrenia n=30

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  Discussion Top


Current study reveals that most of the Schizophrenia patients (80.0%, n=24) were having knowledge regarding the adverse effects of smoking between the score of 12–23 and the rest (20.0%, n=6) were having the knowledge between the score of 0-11 which may be due to the fact that all patients diagnosed with any mental disorder and their family members in LGBRIMH usually gets psychoeducation on the related areas. However, this finding is consistent with the findings of the study conducted by Tariq A et al in Saudi Arabia, where the researcher found that majority (90.5%) of the participants (n=264) knew that smoking is harmful to the health8.

The present study also shows that most (96.66%) of the persons with schizophrenia got information regarding adverse effects of smoking from media messages, which is again consisted with the study findings conducted by Tiwari et al in rural community of Kerala, where it has been found that media sources, i.e. electronic (58.7%) and print media (44.7%)were the common source of knowledge about smoking9.

Limitations: The sample size of the study is very small hence generalizability of findings is not possible.


  Conclusion Top


This study has shown that the overall knowledge regarding adverse effects of tobacco of the patients having Schizophrenia was high which indicates that motivation enhancement among the patients having Schizophrenia to quit smoking might be a helpful smoking cessation strategy. The study results also showed that these patients got the smoking related information mainly from the mass media and also from their family members, which again reflects that the family members and Effective media campaigns can be beneficial for motivating tobacco users in joining tobacco cessation program.



 
  References Top

1.
Lal PG, Wilson NC, Gupta PC. Attributable deaths from smoking in the last 100 years in India. [serial online] 10th Nov 2012 [cited 27th July 2016]; 103(9). Available from: URL: http://www.indiaenvironmentportal.org.in/…/deaths%20from %20smoking.pdf.  Back to cited text no. 1
    
2.
Hassan Z, Ali K, Mostafa V. Prevalence of Cigarette Smoking in Schizophrenic Patients Compared to Other Hospital Admitted Psychiatric Patients. Addict Health. [serial online] 2009 [cited 10th Aug 2018]; 1(1): 38 –42. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3905500/.  Back to cited text no. 2
    
3.
Kelly C, McCreadie R. Cigarette smoking and schizophrenia. [serial online] [cited 26th Apr 2016]. Available from: http://apt.rcpsych.org/content/6/5/327.full.  Back to cited text no. 3
    
4.
Oliveria RMD, Junior ACS, Santos JLF, Furegato ARF. Nicotine dependence in the mental disorders, relationship with clinical indicators, and the meaning for the user. Rev. Latino-Am. Enfermagem. [Online]July-Aug 2014[cited 10th Aug 2018]; 22(4):685-92. doi: 10.1590/01041169.3549.2468.  Back to cited text no. 4
    
5.
Jiang J, See YM, Subramaniam, Lee J. Investgation of cigarette smoking among male schizophrenia patients. PLoS ONE. [online] Aug 2013[cited 10th Aug 2018]. 8(8): e71343. doi:10.1371/journal.pone.0071343.  Back to cited text no. 5
    
6.
Berk M, Ng F, Wang WV, Tohen M, Lubman DI, Vieta E, Dodd S. Going up in smoke: tobacco smoking is associated with worse treatment outcomes in mania. J Affect Disord. 2008; 110(1-2): 126- 34.  Back to cited text no. 6
    
7.
Smoking cessation for persons with mental illnesses. [internet] Jan 2009[cited 24th Nov 2016]. Available at: URL: http://www.integration.samhsa.gov/Smoking_Cessation_for _Persons_with_MI.pdf.  Back to cited text no. 7
    
8.
Tariq A, Naseem A. Smoking among male psychiatric outpatients in Saudi Arabia. Ann Saudi Med. [serial online] 2000[cited 17th Nov 2016]: 20(3-4):218-223. Available from: URL: http://www.kfshrc.edu.sa/annals/Old/203_204/99- 216R.PDF.  Back to cited text no. 8
    
9.
Tiwari R. Tobacco use and cardiovascular disease: A knowledge, attitude and practice study in rural Kerala. Indian Journal of Medical Science. [serial online] 2006 [cited 2nd Jan 2016]; 60 (7 ): 2 7 1 -6. Available from: URL:http://www.indianjmedsci.org/article.asp?issn=0019- 5359;year=2006;volume=60;issue=7;spage=271;epage=27 6;aulast=Tiwari.  Back to cited text no. 9
    



 
 
    Tables

  [Table 1], [Table 2], [Table 3], [Table 4], [Table 5]



 

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