title: Perceived health risks, attitude and readiness to quit tobacco among euthymic bipolar disorder patients in regular contact with mental health services: an exploratory study from India.
abstract: BACKGROUND
  Patients with bipolar disorder (BD) are at higher risk of tobacco-related harm compared with general population. However, they may not fully appreciate health risks even when asymptomatic.
  
  
  OBJECTIVE
  The study aims to explore the perceived health risks, attitude and readiness to quit tobacco among euthymic BD patients.
  
  
  METHODS
  The adult male outpatients with Diagnostic and Statistical Manual, 4th edition diagnosis of BD type I and nicotine dependence were selected if they were euthymic and in regular psychiatric follow-up (n = 50). They were assessed using Fagerstrom scale for nicotine dependence, transtheoretical model and a semi-structured questionnaire.
  
  
  RESULTS
  The sample was unaware of the full spectrum of tobacco health risks and most of patients could report only one or two tobacco-related diseases. Though the majority correctly recalled the pack health warning, but felt that it should not be taken seriously. The sample perceived its own cancer risk to be lower than that of an average user of similar age. The non-readiness to change tobacco use was predicted by difficulty in quitting due to mood disorder (odds ratio (OR) 0.229) and a higher perceived ability to quit (OR 0.328).
  
  
  CONCLUSIONS
  The knowledge and risk perception for tobacco remains inadequate even among the stable BD type I patients in regular contact with mental health services.
authors.affiliation: Department of Psychiatry, All India Institute of Medical Sciences, New Delhi, India. drrajeshsagar@gmail.com
authors.forename: Raman Deep
authors.initials: RD
authors.lastname: Pattanayak
authors.forename: Rajesh
authors.initials: R
authors.lastname: Sagar
authors.forename: Raka
authors.initials: R
authors.lastname: Jain
mesh_terms: D000328:Adult; D001294:Attitude to Health; D001364:Awareness; D001714:Bipolar Disorder / Q000150:complications / Q000523:psychology*; D015438:Health Behavior; D006801:Humans; D007194:India; D008297:Male; D008605:Mental Health Services; D016017:Odds Ratio; D010349:Patient Compliance / Q000523:psychology*; D012306:Risk; D016540:Smoking Cessation / Q000379:methods / Q000523:psychology*; D011795:Surveys and Questionnaires; D014029:Tobacco Use Disorder / Q000150:complications / Q000523:psychology / Q000628:therapy*