Smoking and mental health - NCSCT

Smoking among people with mental disorders 2
2.11 Supplementary APMS survey data on special populations
In the 1996 APMS supplementary survey of those living in institutions catering
for people with mental illness three categories of mental disorder were examined:
those with a diagnosis of schizophrenia, delusional or schizoaffective disorders
(around 70% of the sample); affective psychoses (mania and bipolar affective
disorder – around 8%); and ‘neurotic disorders’ (those with a diagnosis of
generalised anxiety disorder, depressive episode, mixed anxiety and depressive
disorder, phobia, obsessive–compulsive disorder and panic disorder – around
8%). Of the remainder, 5% had other mental disorders and in 9% data were
insufficient to enable classification. Smoking prevalence among those with these
disorders is shown in Table 2.9, and reflects rates approximately three times
higher than the 27% in the general population at the time. 23 Among homeless
people, smoking prevalence was also high at 71% overall, and 84% among
residents of night shelters (84%) and 91% in those sleeping rough. Among
prisoners surveyed in 1997, 82% reported smoking, when the prevalence of
smoking in the general population was still 27%.
Table 2.9 Prevalence of smoking in special population groups
Sample and diagnosis Year of N a Smoking
survey
prevalence
(95% CI) b
Institutional sample
Schizophrenia, delusional and 1994 856 81.8 (77.5–85.3)
schizoaffective disorders
Affective psychosis 1994 101 78.2 (64.1–87.9)
Neurotic disorders 1994 78 73.9 (60.4–84.2)
Homeless people 1994 1,166 71.2 (67.6–74.8)
Prisoners 1997 3,107 81.8 (80.4–83.1)
a Unweighted (previous published data from the institutional survey have been based on a
smaller subset of participants who also provided information on alcohol and drug use).
b Weighted to account for survey design.
CI, confidence interval.
2.12 Summary
> Smoking is around twice as common among people with mental disorders,
and more so in those with more severe disease.
> Up to 3 million smokers in the UK, 30% of all smokers, have evidence of
mental disorder and up to 1 million with longstanding disease.
© Royal College of Physicians 2013 35