title: Smoking and nicotine dependence in Singapore: findings from a cross-sectional epidemiological study.
abstract: BACKGROUND
  Smoking is one of the leading preventable causes of death throughout the world and can lead to nicotine dependence, particularly when initiated at a young age. This paper describes the prevalence of smoking and nicotine dependence in the adult Singapore resident population, whilst also exploring rates among the major ethnic groups (Chinese, Malay and Indian), different education levels and those with chronic psychiatric and physical comorbidities.
  
  
  METHODS
  The Singapore Mental Health Study (SMHS) is a cross-sectional epidemiological study that was conducted between December 2009 and December 2010. Information on smoking status was assessed using the Composite International Diagnostic Interview version 3.0 (CIDI 3.0) and the Fagerstrom Test for Nicotine Dependence measured nicotine dependence. Socio-demographic information was also collected.
  
  
  RESULTS
  In total, 6616 respondents participated in the SMHS giving a response rate of 75.9%. We found that 16% of the population were current smokers and 4.5% had nicotine dependence. Current smokers were more likely to be younger (18 to 34 years old), males, Malay and have lower education, whilst males had a 4.6 times higher risk of nicotine dependence to that of females. The prevalence of nicotine dependence was also higher in those with alcohol abuse and those experiencing chronic pain.
  
  
  CONCLUSIONS
  The results from this study highlight the important differences in the prevalence of smoking and nicotine dependence among different age groups, gender and ethnicity in Singapore and are important for developing future health policies and targeted preventive strategies.
authors.affiliation: Research Division, Institute of Mental Health, Buangkok Green Medical Park, 10 Buangkok View, Singapore 539747. louisa_picco@imh.com.sg
authors.forename: Louisa
authors.initials: L
authors.lastname: Picco
authors.forename: Mythily
authors.initials: M
authors.lastname: Subramaniam
authors.forename: Edimansyah
authors.initials: E
authors.lastname: Abdin
authors.forename: Janhavi A
authors.initials: JA
authors.lastname: Vaingankar
authors.forename: Siow Ann
authors.initials: SA
authors.lastname: Chong
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002681:China / Q000208:ethnology; D003430:Cross-Sectional Studies; D004522:Educational Status; D016021:Epidemiologic Studies; D005260:Female; D006801:Humans; D007214:Indonesia / Q000208:ethnology; D008296:Malaysia / Q000208:ethnology; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009538:Nicotine; D015995:Prevalence; D012307:Risk Factors; D012737:Sex Factors; D012846:Singapore / Q000453:epidemiology; D012907:Smoking / Q000453:epidemiology* / Q000208:ethnology; D000074606:Smoking Prevention; D019966:Substance-Related Disorders / Q000453:epidemiology* / Q000208:ethnology / Q000517:prevention & control; D055815:Young Adult
chemical_list: D009538:Nicotine