title: Cigarette smoking, nicotine dependence, and motivation for smoking cessation in psychiatric inpatients.
abstract: OBJECTIVE
  Cigarette smoking is the leading preventable cause of death and disease in Canada, and is disproportionately more frequent among psychiatric patients. Smoking cessation interventions can be successfully implemented with psychiatric patients, yet no Canadian studies have evaluated smoking prevalence, nicotine dependence, and motivation for smoking cessation in psychiatric inpatients. Our study did so to help plan appropriate interventions for these patients.
  
  
  METHODS
  All inpatients aged 18 years or older admitted to acute-care psychiatry units at the Foothills Medical Centre in Calgary, Alberta, during a 6-month period completed a survey involving questions from the Canadian Tobacco Use Monitoring Survey, the Fagerstrom Test for Nicotine Dependence (FTND), the Readiness to Quit Ladder, and the Decisional Balance for Cigarette Smoking. Responses were analyzed for correlation with discharge diagnoses, age, and sex.
  
  
  RESULTS
  Among the total inpatients (n = 342), 211 (62%) completed the survey. Among those, 55% were current cigarette smokers and 17.5% were former smokers. Nicotine dependence (FTND > or = 6) was reported in 45.2% of smokers. Smoking prevalence and nicotine dependence severity was greatest in the substance use disorders (SUD) and psychotic disorders groups. Current smokers endorsed more negative than positive attributes of smoking. Regarding smoking cessation, 51% of patients were precontemplative, 12.7% contemplative, and 36.2% preparatory or action-oriented, despite few receiving advice to quit.
  
  
  CONCLUSIONS
  Cigarette smoking and nicotine dependence are highly prevalent in psychiatric inpatients. However, self-reported motivation for smoking cessation is noteworthy, emphasizing that cessation advice and appropriate follow-up care should be provided to psychiatric inpatients who smoke.
authors.affiliation: Psychiatry Resident, Department of Psychiatry, University of Calgary, Calgary, Alberta.
authors.forename: Heidi
authors.initials: H
authors.lastname: Solty
authors.forename: David
authors.initials: D
authors.lastname: Crockford
authors.forename: William D
authors.initials: WD
authors.lastname: White
authors.forename: Shawn
authors.initials: S
authors.lastname: Currie
mesh_terms: D000328:Adult; D005260:Female; D006293:Health Promotion; D006760:Hospitalization; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D009042:Motivation; D015995:Prevalence; D011618:Psychotic Disorders / Q000453:epidemiology* / Q000534:rehabilitation*; D012907:Smoking / Q000453:epidemiology*; D016540:Smoking Cessation / Q000379:methods* / Q000706:statistics & numerical data*; D000074606:Smoking Prevention; D011795:Surveys and Questionnaires; D014029:Tobacco Use Disorder / Q000453:epidemiology* / Q000517:prevention & control*