Prevalence of smoking, quit attempts and access to cessation treatment among adults with mental illness in Brazil: a cross-sectional analysis of a National Health Survey

Abstract

ObjectivesDetermine the national prevalence of smoking and factors related to smoking among adults with mental illness (PLWMI; people living with mental illness) in Brazil.DesignCross-sectional study.SettingWe used data from the nationally representative general health survey Pesquisa Nacional de Saude of 2013, which included the Global Adult Tobacco Survey (GATS) module.ParticipantsThe survey used a complex probabilistic sample to collect data from 60 202 Brazilians 18 years or older. Primary and secondary outcomes: smoking prevalence and access to smoking cessation treatment. We also assessed past tobacco use, quit attempts and quit ratio among people with and without mental illness. Analyses were conducted in R and were weighted to account for the survey design and generate national estimates.ResultsIn Brazil, the 2013 smoking prevalence among PLWMI was 28.4% and among people with no mental illness was 12.8%. Both groups had high rates of past-year quit attempts (51.6% vs 55.3%) but the lifetime quit ratio among PLWMI was much lower than those with no mental illness (37% vs 54%). Adjusted odds showed PLWMI were more likely to be current smokers (OR (95% CI)=2.60 (2.40 to 2.82), less likely to be former smokers (OR (95% CI)=0.62 (0.55 to 0.70)) and as likely to have tried to quit in the past year (OR (95% CI)=0.90 (0.78 to 1.02)). Very few (3.7%) PLWMI and fewer with no mental illness (2.6%) received cessation treatment.ConclusionSmoking rates among PLWMI are roughly double the rate in the general population. Compared with Brazilian smokers without mental illness, those with mental illness were significantly less likely to quit even though as many tried to. Few Brazilians appear to be using publicly available cessation services. Expanding utilisation of treatment might be a good place to start for Brazil to further decrease the prevalence of smoking among PLWMI.

Trends in Smoking Prevalence and Intensity between 2010 and 2018: Implications for Tobacco Control in China

“…In Thailand, the smoking prevalence among people aged 15 years old or above decreased from 32.0% in 1991 to 19.1% in 2017 [ 28 ]. In 2014 across Brazil, approximately 15% of the population were smokers, down from 34.8% in 1989 [ 29 ].…”

Impacts and interactions of COVID-19 response involvement, health-related behaviours, health literacy on anxiety, depression and health-related quality of life among healthcare workers: a cross-sectional study

“…76 77 In addition, the smoking rates are higher in people with mental health problems than in the general population. 78 Alcohol consumption has been associated with reduction of tensions, which has a positive impact on mental health. 79 Even so, smoking still considered harmful to HRQoL in the current study, consistent with the previous studies.…”

Análise prognóstica de um programa de tabagismo entre pacientes com comorbidade psiquiátrica

“…Estes indivíduos também tendem a ser fumantes mais graves. Além disso, dados sugerem que indivíduos com mais de um transtorno (i.e., comorbidade) tendem a fumar mais cigarros por dia Mazure;McKee, 2014;Cruvinel et al, 2020;Johnson et al, 2020).…”

“…Estas crenças são invalidadas por estudos que investigam os efeitos da cessação do tabaco entre pacientes psiquiátricos, demonstrando que não somente esses indivíduos conseguem parar, como também se beneficiam da cessação (Schroeder;Morris, 2010;Peckham et al, 2017). Em estudo recente conduzido com a população brasileira, foram identificados 28,4% de fumantes regulares com algum tipo de transtorno mental, sendo que 55,3% deles reportaram tentar parar no último ano (Cruvinel et al, 2020). Ao analisar por categoria diagnóstica, o estudo também identificou 32,3% de fumantes com beber prejudicial, 20,9% de fumantes com depressão, 33,3% de fumantes com esquizofrenia, 25,3% de fumantes com transtorno compulsivo-obsessivo (TOC), 20,9% de fumantes com transtorno afetivo bipolar (TAB) e 17,9% de fumantes com outros transtornos.…”

“…Os autores ainda consideram que o número de fumantes entre indivíduos com transtorno mental identificados no estudo pode ter sido subestimado, pois aqueles com condições mais graves podem não ter participado do levantamento (i.e., preenchimento do GATS na pesquisa nacional em saúde -PNS) e aqueles com transtornos mais leves podem não os ter declarado (Cruvinel et al, 2020).…”