Prevalence of tobacco dependence and associated factors among patients with schizophrenia attending their treatments at southwest Ethiopia; hospital-based cross-sectional study

Background
Tobacco smoking is the most typically employed in patients with mental disorders; among them, patients with schizophrenia are the very best users. The rate of smoking among patients with schizophrenia is between two and three times greater than the general population in western countries. However, there is a scarcity of studies on the magnitude and associated factors of tobacco dependence among patients with schizophrenia in Ethiopia. Therefore, we assessed the prevalence of tobacco dependence and associated factors among patients with schizophrenia at Mettu Karl referral, Bedelle, and Agaro hospitals, Southwest, Ethiopia.

Method
Hospital-based the multistage stratified cross-sectional study design was conducted among 524 patients with schizophrenia who are on treatment. Fagerstrom Test for Nicotine Dependence (FTND) was used to screen the prevalence of tobacco dependence. Analysis of data was done using SPSS version 24.

Result
The prevalence of tobacco dependence among study participants was 22.3% (95% CI) (18.6, 26). Concerning the severity of tobacco dependence, 3.5%, 13.8%, and 5% of the respondents report moderate, high, and very high levels of tobacco dependence respectively. The proportions of tobacco dependence among male schizophrenic patients 88 (25.8%) were higher compared to their counterparts 27 (15.5%). After controlling the effects of cofounders in the final regression analysis, male gender (AOR 2.19, 95% CI = 1.25, 3.83), being on treatment for more than 5years (AOR 4.37, 95% CI = 2.11, 9.02), having a history of admission (AOR 4.01, 95% CI = 1.99, 8.11), and family history of mental illness (AOR 1.90, 95% CI = 1.04, 3.48) were shown to have a significant positive association with tobacco dependence.

Conclusion and recommendation
A study show a significant proportion of tobacco dependence among people living with schizophrenia. Factors like, being male gender, being on treatment for more than 5 years, having a history of admission, and family history of mental illness was found to have a significant positive association with tobacco dependence. Hence, there is a need for coordinated and comprehensive management clinically to manage tobacco dependence along with identified risk factors in patients with schizophrenia. Also the finding call for the clinicians, managers, ministry of health and other stakeholders on the substance use prevention strategies that target personal and environmental control.