Prevalência do tabagismo e seus fatores associados entre pacientes com transtorno mental no Brasil

• Ano de defesa: 2012
• Autor(a) principal: Fabiana Cristina Ribeiro de Barros
• Tipo de documento: Dissertação
• Tipo de acesso: Acesso aberto
• Idioma: por
• Instituição de defesa: Universidade Federal de Minas Gerais; UFMG
• Palavras-chave em Português: Brasil; Transtorno mental; Tabagismo; Fatores de risco; Estudo multicêntrico; Fatores epidemiológicos; Inquéritos de morbidade; Transtornos mentais
• Link de acesso: http://hdl.handle.net/1843/BUOS-972FFM

Psychiatric patients have a higher prevalence of tobacco smoking than the general population, and the greater the severity of his diagnosis the more likely to be smokers. Compared to the general population, there is substantial excess mortality in people with mental illness mainly due to cardiovascular and respiratory diseases, andsmoking is one of the risk factors for this excess risk of death. Nevertheless, there are few studies on this subject published in Brazil, and none with a representative sample of this population. The aims of the present study were to estimate the prevalence and to assess factors associated with tobacco smoking among psychiatric patients in Brazil. This study is part of PESSOAS Project, a national cross-sectional multicenter study of patients with chronic mental illness (N=2475), randomly selected from 26 psychiatric centers (CAPS and psychiatric hospitals). Sociodemographic, clinical and behavioral data were collected by face-to-face interview and from medical charts. Participants were defined as current smokers (thosewho reported smoking at least one commercial or hand-rolled tobacco cigarette per dayat the time of the interview), ex-smokers (those who used to smoke at least one commercial orhand-rolled tobacco cigarette per day, but did not smoke at time of the interview), and non-smokers (those who had never smoked). Current and ex-smokers were compared, separately, with those who never smoked using multinomial logistic regression. The significance level considered was 0.05. Among 2475 participants initially interviewed, 14 did not answer the questions about smoking. Among 2461 patients analyzed, 53% were smokers and 19% were ex-smokers. Most of patients were under treatment at CAPS at the time of interview (64%), were female (52%), 40 years old or older (55%), with low schooling (82%), not married (67%), who practiced some religion (55%), had severe psychiatric diagnoses (57%), and had a history of previous psychiatric hospitalizations (55%). Lifetime alcohol use (65%) was higher than illicit drug use (26%), and more than half practiced unsafe sex (81%) and had suffered physical violence (58%). Factors independently associated with both, current or ex-smokers, were: male gender, age 40 years old, and vulnerability markers, as lifetime alcoholand illicit drug use, unsafe sex, and physical violence. In addition, low schooling, history of homelessness, not practicing a religion, current hospitalization, substance use asthe main psychiatric diagnosis, and previous psychiatric hospitalization were independently associated with current smoking only. The prevalence of tobacco smoking among psychiatric population in Brazil was high, and higher than the estimates for the general population, contrary to the observed decrease trend of smoking in the country. Factors that indicate the severity of the psychiatric condition (e.g. hospitalization, diagnosis) associated only with current smoking may indicate greater difficulties of smoking cessation in this group. More studies are needed to better understand these results. However, mental health services should adopt intervention policies, including screening, prevention and smoking cessation programs.