Prevalence and Correlates of Cigarette Smoking in Adolescent Psychiatric Inpatients in Iran: A Cross-Sectional Study and Narrative Review

Context: Smoking in adolescence is a worldwide health problem. Understanding the prevalence of smoking and its clinical correlates in adolescent inpatients is useful for mental health staff to plan effective programs to reduce its detrimental consequences. In this study, we investigated the prevalence and correlates of cigarette smoking and its sociodemographic and clinical correlates. We performed a narrative review of cigarette smoking prevalence among adolescents as well as a descriptive study in inpatient adolescents in Iran. Evidence Acquisition: This was a multicentric, cross-sectional, and hospital-based survey. In total, 82 patients (male/female: 66.9% vs. 33.1%) were consecutively recruited from 5 child and adolescent inpatient psychiatric wards of Iran. The study data were collected from patients, their family members and patients' medical records. The descriptive statistics, Pearson's chi-squared test, and univariate logistic regression analyses were employed to analyze the obtained data. Additionally, we added a narrative review to understand the prevalence rate of smoking and its clinical correlates in adolescent inpatients. Results: The prevalence rate of smoking was 30% in our study sample (24.5% in boys and 39.5 % in girls). There was a significant association between smoking with family size, history of suicide attempt, physical illness, drug misuse in patients, and alcohol or drug misuse in family members. The prevalence of mood disorders in the nonsmokers and smokers were 37.5% and 62.5%, respectively. Overall, 26.6% of the subjects had a history of suicide attempt of whom, 52.9% were smokers. Conclusions: Results of this study about the association between smoking with family size, history of suicide attempt, physical illness, drug misuse, and other related factors, call for both careful screening of smoking and specially designed integrated psychiatric/smoking treatments in these patients.