Experiences of Tobacco Use among Chinese Individuals with Schizophrenia in Community-Based Residential Settings: A Qualitative Study.

Yim Wah Mak,Alice Yuen Loke,Vico C L Chiang

doi:10.3390/ijerph17010321

Abstract

Although there is a high prevalence of smoking among individuals with schizophrenia, no previous attempt has been made to explore experiences of tobacco use and cessation within a Chinese sample of this population. A qualitative descriptive study was conducted to explore through the use of individual and semi-structured interviews the experiences of tobacco use and quitting in a sample Chinese population with schizophrenia. Twenty-three eligible participants with schizophrenia who currently smoke were recruited from three community residential mental health service settings. Four main themes representing the experiences of the participants were uncovered in this study: (1) smoking and illness; (2) environment and culture; (3) reasons for smoking; and (4) beliefs about cessation methods. The findings indicated that the participants considered the disease to be far more harmful than smoking, and perceived many benefits to smoking. Although some thought of quitting at times, most gave up the idea or failed to quit due to internal factors such as disease-related suffering, the use of an avoidance coping strategy, and a lack of cessation support. The most notable finding concerns the use of avoidance coping by the participants, who relied on smoking as a way to avoid the suffering brought about by the disease.

Highlights

People with schizophrenia have about a 20% lower life expectancy than the general population [1,2]Smoking is believed to account for the majority of the excess mortality among individuals with schizophrenia [3,4,5,6,7], with such smokers being at a twelve times greater risk of dying from cardiac-related illnesses than non-smokers with schizophrenia [8]
Individuals with schizophrenia have the highest prevalence of smoking, a higher dependence on nicotine, and a significantly lower smoking cessation rate than is the case among the general population and among smokers with other psychiatric illnesses [9,10,11,12,13]
They were ambivalent about smoking and quitting at times, the feeling was not strong enough to prompt many of them to quit, due to the lack of cessation support that they received throughout their journey of recovering from mental illness

Summary

Introduction

People with schizophrenia have about a 20% lower life expectancy than the general population [1,2]Smoking is believed to account for the majority of the excess mortality among individuals with schizophrenia [3,4,5,6,7], with such smokers being at a twelve times greater risk of dying from cardiac-related illnesses than non-smokers with schizophrenia [8]. People with schizophrenia have about a 20% lower life expectancy than the general population [1,2]. Individuals with schizophrenia have the highest prevalence of smoking, a higher dependence on nicotine, and a significantly lower smoking cessation rate than is the case among the general population and among smokers with other psychiatric illnesses [9,10,11,12,13]. Various studies have been conducted exploring the reasons for the high prevalence of smoking among people with schizophrenia. Only one study has explored beliefs and attitudes regarding the smoking behaviors of people with schizophrenia [22]. The study found that people with chronic schizophrenia believed that smoking could help to relieve their anxiety and negative symptoms, and were not thinking of quitting smoking.

Objectives

Methods

Results

Discussion

Conclusion