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The 13th World Conference on Tobacco OR Health

Building capacity for a tobacco-free world

July 12-15, 2006, Washington, DC, USA

Thursday, July 13, 2006 - 12:00 PM

Getting to the Heart of the Problem: Tobacco Use and Other Comorbid Conditions of Psychiatric Patients

Cynthia L. Dakin, PhD, RN, Bouve College of Health Sciences School of Nursing, Northeastern University, 102 Robinson Hall, Boston, MA 02115-5000

Objective: The purpose of this study was to answer the research questions: (1) What are the most frequent medical comorbidities of patients admitted to an acute care psychiatric hospital? (2) What are the characteristics of psychiatric patients who use tobacco? (3) Is there a relationship between admitting psychiatric diagnosis and tobacco use? (4) Is there a relationship between tobacco use and medical comorbidities in psychiatric patients?

Methods: A retrospective chart review was conducted using random sampling (n=1097) of patients admitted to an acute care psychiatric hospital over 10 months to identify medical comorbidities.

Results: Sample characteristics show a range of age 18 to 93 years; gender 41% male, 59% female. Of the patient records with tobacco use documentation (n=784), 55% used tobacco; 52% were male, 48% were female; 8% smoked < 15 cigarettes/day, 26% smoked ≥ 15 cigarettes/day and < 1 ppd, and 66% smoked ≥ 1 ppd. The most frequent admitting DSMIV diagnoses across three admitting diagnoses were major depressive disorder 35% (n=387), substance intoxication, dependence, or abuse 30% (n=332), bipolar disorder 24% (n=267), and schizophrenia 13% (n=143). The most frequently occurring medical comorbidities were hypertension 22.3%, gastroesophageal reflux disease 13.9%, asthma 11.2%, chronic pain 10.3%, hypothyroidism 8.7%, chronic headaches/migraines 8.4%, and diabetes mellitus II (NIDDM) 7.2%. Forty-eight percent of the sample reported more than one medical comorbidity. Tobacco use was found to be significantly related to several comorbidities: hypertension, NIDDM, cancer, osteoporosis, previous stroke, and cardiac disease. Follow-up tobacco cessation research is planned for early 2006 at the same psychiatric facility.