Abstract
BACKGROUND: In China, the coexistence of mental illness and tobacco dependence is a major public health issue. With around 300 million smokers and over one million annual smoking-related deaths, the resulting social and economic burdens are considerable. METHODS: A cross-sectional study design was employed to gather data on tobacco use, readiness to quit smoking, and nicotine dependence from a random sample of 738 patients diagnosed with severe mental illness. Data analysis, which included descriptive statistics and multivariate logistic regression analysis, was conducted via SPSS 27.0. RESULTS: The findings revealed that the smoking prevalence among patients with severe mental illness was 52.03%, significantly higher than that of the general population. Multifactorial logistic regression analysis indicated that male gender(OR=10.041, 95% CI: 6.499-15.513), Han ethnicity(OR=3.263, 95% CI: 1.053-10.108), worse economic status (OR=2.540, 95% CI: 1.424-4.529), family history of smoking (OR=6.474, 95% CI: 4.211-9.952), outpatient status(OR=2.294, 95% CI: 1.433-3.674), family history of mental illness (OR=1.756, 95% CI: 1.129-2.731), history of drug exposure(OR=2.074, 95% CI: 1.244-3.458), and history of alcohol consumption(OR=5.216, 95% CI: 3.037-8.960) were independent risk factors for smoking in this patient group. Furthermore, there were significant differences in nicotine dependence levels across different psychiatric diagnoses, with patients diagnosed with schizophrenia and bipolar disorder exhibiting higher levels of nicotine dependence compared to those with paranoid disorder who showed lower levels. CONCLUSIONS: The study elucidates the complex nature and critical determinants of tobacco use patterns among individuals with severe mental illness, providing a solid scientific foundation for developing targeted intervention strategies. CHINA CLINICAL TRIAL REGISTRY REGISTRATION NUMBER: ChiCTR2400088459.