Skip to main content

Correlates of Secondhand Tobacco Smoke Exposure Among Persons with Severe and Persistent Mental Illness (SPMI) Accessing Community Mental Health Services

Community Mental Health Journal volume 45, pages 188–198 (2009)Cite this article

Abstract

To examine the correlates of secondhand tobacco smoke (SHS) exposure in a sample of individuals with severe and persistent mental illness (SPMI) accessing community mental health services. Cross-sectional data were collected from a voluntary sample of 788 individuals with SPMI. Nonsmokers were more likely to be exposed on the street or at a bus stop, in a park or public place; whereas smokers were more likely to report SHS exposure where they lived and at their friend’s homes. In a multivariate model, only number of acquaintances who smoked and the number of sources of SHS exposure remained significantly associated with perceived frequency of SHS exposure when accounting for other correlates. There is a need for the enactment and enforcement of policies to curtail SHS exposure in outdoor, public, settings. Future research will be necessary to better understand the extent and impact of SHS exposure in this population.

This is a preview of subscription content, access via your institution.

Access options

Buy single article

Instant access to the full article PDF.

USD 39.95

Price includes VAT (USA)
Tax calculation will be finalised during checkout.

References

  • Al-Delaimy, W. K., & Willett, W. C. (2008). Measurement of tobacco smoke exposure: Comparison of toenail nicotine biomarkers and self-Reports. Cancer Epidemiology, Biomarkers and Prevention, 17(5), 1255–1261. doi:10.1158/1055-9965.EPI-07-2695.

    PubMed  Article  CAS  Google Scholar 

  • Barnoya, J., & Glantz, S. A. (2005). Cardiovascular effects of secondhand smoke: Nearly as large as smoking. Circulation, 111(20), 2684–2698. doi:10.1161/CIRCULATIONAHA.104.492215.

    PubMed  Article  Google Scholar 

  • Beratis, S., Katrivanou, A., & Gourzis, P. (2001). Factors affecting smoking in schizophrenia. Comprehensive Psychiatry, 42(5), 393–402. doi:10.1053/comp.2001.26273.

    PubMed  Article  CAS  Google Scholar 

  • Bonner, M. R., Nie, J., Han, D., Vena, J. E., Rogerson, P., Muti, P., et al. (2005). Secondhand smoke exposure in early life and the risk of breast cancer among never smokers (United States). Cancer Causes and Control, 16(6), 683–689. doi:10.1007/s10552-005-1906-x.

    PubMed  Article  Google Scholar 

  • Brennan, P., Buffler, P., Reynolds, P., Wu, A. H., Wichmann, H. E., Agudo, A., et al. (2004). Secondhand smoke exposure in adulthood and risk of lung cancer among never smokers: A pooled analysis of two large studies. International Journal of Cancer, 109(1), 125–131. doi:10.1002/ijc.11682.

    Article  CAS  Google Scholar 

  • Brownson, R. C., Eriksen, M. P., Davis, R. M., & Warner, K. E. (1997). Environmental tobacco smoke:Health effects and policies to reduce exposure1. Annual Review of Public Health, 18(1), 163. doi:10.1146/annurev.publhealth.18.1.163.

    PubMed  Article  CAS  Google Scholar 

  • Burghuber, O. C., Punzengruber, C., Sinzinger, H., Haber, P., & Silberbauer, K. (1986). Platelet sensitivity to prostacyclin in smokers and non-smokers. Chest, 90(1), 34–38. doi:10.1378/chest.90.1.34.

    PubMed  Article  CAS  Google Scholar 

  • Cameron, M., Wakefield, M., Trotter, L., & Inglis, G. (2003). Exposure to secondhand smoke at work: A survey of members of the Australian liquor, hospitality and miscellaneous workers union. Australian and New Zealand Journal of Public Health, 27(5), 496–501. doi:10.1111/j.1467-842X.2003.tb00821.x.

    PubMed  Article  Google Scholar 

  • Chan-Yeung, M., & Dimich-Ward, H. (2003). Respiratory health effects of exposure to environmental tobacco smoke. Respirology (Carlton, Vic.), 8(2), 131–139. doi:10.1046/j.1440-1843.2003.00453.x.

    Google Scholar 

  • Cummings, K. M., Markello, S. J., Mahoney, M., Bhargava, A. K., McElroy, P. D., & Marshall, J. R. (1990). Measurement of current exposure to environmental tobacco smoke. Archives of Environmental Health, 45(2), 74–79.

    PubMed  CAS  Google Scholar 

  • de Leon, J., & Diaz, F. J. (2005). A meta-analysis of worldwide studies demonstrates an association between schizophrenia and tobacco smoking behaviors. Schizophrenia Research, 76(2–3), 135–157. doi:10.1016/j.schres.2005.02.010.

    PubMed  Article  Google Scholar 

  • de Leon, J., Diaz, F. J., Rogers, T., Browne, D., & Dinsmore, L. (2002). Initiation of daily smoking and nicotine dependence in schizophrenia and mood disorders. Schizophrenia Research, 56(1–2), 47–54. doi:10.1016/S0920-9964(01)00217-1.

    PubMed  Article  Google Scholar 

  • Diwan, A., Castine, M., Pomerleau, C. S., Meador-Woodruff, J. H., & Dalack, G. W. (1998). Differential prevalence of cigarette smoking in patients with schizophrenic vs mood disorders. Schizophrenia Research, 33(1–2), 113–118. doi:10.1016/S0920-9964(98)00045-0.

    PubMed  Article  CAS  Google Scholar 

  • Dombrowski, S. C., Martin, R. P., & Huttunen, M. O. (2005). Gestational exposure to cigarette smoke imperils the long-term physical and mental health of offspring. Birth Defects Research (Part A). Clinical and Molecular Teratology, 73(3), 170–176. doi:10.1002/bdra.20126.

    Article  CAS  Google Scholar 

  • Eisner, M. D., Klein, J., Hammond, S. K., Koren, G., Lactao, G., & Iribarren, C. (2005). Directly measured second hand smoke exposure and asthma health outcomes. Thorax, 60(10), 814–821. doi:10.1136/thx.2004.037283.

    PubMed  Article  CAS  Google Scholar 

  • Ennett, S. T., & Bauman, K. E. (1993). Peer group structure and adolescent cigarette smoking: A social network analysis. Journal of Health and Social Behavior, 34(3), 226–236. doi:10.2307/2137204.

    PubMed  Article  CAS  Google Scholar 

  • Fergusson, D. M., Goodwin, R. D., & Horwood, L. J. (2003). Major depression and cigarette smoking: Results of a 21-year longitudinal study. Psychological Medicine, 33, 1357–1367. doi:10.1017/S0033291703008596.

    PubMed  Article  CAS  Google Scholar 

  • Gatzke-Kopp, L., & Beauchaine, T. (2007). Direct and passive prenatal nicotine exposure and the development of externalizing psychopathology. Child Psychiatry and Human Development, 38(4), 255–269. doi:10.1007/s10578-007-0059-4.

    PubMed  Article  Google Scholar 

  • Gorlova, O. Y., Zhang, Y., Schabath, M. B., Lei, L., Zhang, Q., Amos, C. I., et al. (2006). Never smokers and lung cancer risk: A case-control study of epidemiological factors. International Journal of Cancer, 118(7), 1798–1804. doi:10.1002/ijc.21561.

    Article  CAS  Google Scholar 

  • Grant, B. F., Hasin, D. S., Chou, S. P., Stinson, F. S., & Dawson, D. A. (2004). Nicotine dependence and psychiatric disorders in the United States: Results from the national epidemiologic survey on alcohol and related conditions. Archives of General Psychiatry, 61(11), 1107–1115. doi:10.1001/archpsyc.61.11.1107.

    PubMed  Article  Google Scholar 

  • Hahn, E. J., Rayens, M. K., York, N., Okoli, C. T. C., Zhang, M., Dignan, M., et al. (2006). Effects of a smoke-free law on hair nicotine and respiratory symptoms of restaurant and bar workers. Journal of Occupational and Environmental Medicine, 48(9), 906–913. doi:10.1097/01.jom.0000215709.09305.01.

    PubMed  Article  CAS  Google Scholar 

  • Iribarren, C., Friedman, G. D., Klatsky, A. L., & Eisner, M. D. (2001). Exposure to environmental tobacco smoke: Association with personal characteristics and self reported health conditions. Journal of Epidemiology and Community Health, 55(10), 721–728. doi:10.1136/jech.55.10.721.

    PubMed  Article  CAS  Google Scholar 

  • Jaakkola, M., & Jaakkola, J. (1997). Assessment of exposure to environmental tobacco smoke. The European Respiratory Journal, 10(10), 2384–2397. doi:10.1183/09031936.97.10102384.

    PubMed  Article  CAS  Google Scholar 

  • Khuder, S. A., Milz, S., Jordan, T., Price, J., Silvestri, K., & Butler, P. (2007). The impact of a smoking ban on hospital admissions for coronary heart disease. Preventive Medicine, 45(1), 3–8. doi:10.1016/j.ypmed.2007.03.011.

    PubMed  Article  Google Scholar 

  • Klepeis, N. E., Ott, W. R., & Switzer, P. (2007). Real-time measurement of outdoor tobacco smoke particles. Journal of the Air and Waste Management Association, 57, 522–534.

    PubMed  CAS  Article  Google Scholar 

  • Lasser, K., Boyd, J. W., Woolhandler, S., Himmelstein, D. U., McCormick, D., & Bor, D. H. (2000). Smoking and mental illness: A population-based prevalence study. Journal of the American Medical Association, 284(20), 2606–2610. doi:10.1001/jama.284.20.2606.

    PubMed  Article  CAS  Google Scholar 

  • Lawn, S., & Pols, R. (2005). Smoking bans in psychiatric inpatient settings? A review of the research. The Australian and New Zealand Journal of Psychiatry, 39(10), 866–885. doi:10.1111/j.1440-1614.2005.01697.x.

    PubMed  Article  Google Scholar 

  • Lee, K., Hahn, E. J., Pieper, N., Okoli, C. T. C., Repace, J., & Troutman, A. (2008). Differential impacts of smoke-free laws on indoor air quality. Journal of Environmental Health, 70(8), 24–30.

    PubMed  CAS  Google Scholar 

  • Mack, W. J., Islam, T., Lee, Z., Selzer, R. H., & Hodis, H. N. (2003). Environmental tobacco smoke and carotid arterial stiffness. Preventive Medicine, 37(2), 148–154. doi:10.1016/S0091-7435(03)00097-5.

    PubMed  Article  Google Scholar 

  • Makomaski Illing, E. M., & Kaiserman, M. J. (2004). Mortality attributable to tobacco use in Canada and its regions, 1998. Canadian Journal of Public Health, 95(1), 38–44.

    Google Scholar 

  • McCabe, R. E., Chudzik, S. M., Antony, M. M., Young, L., Swinson, R. P., & Zolvensky, M. J. (2004). Smoking behaviors across anxiety disorders. Journal of Anxiety Disorders, 18(1), 7–18. doi:10.1016/j.janxdis.2003.07.003.

    PubMed  Article  Google Scholar 

  • McLellan, A. T., Kushner, H., Metzger, D., Peters, R., Smith, I., Grissom, G., et al. (1992). The fifth edition of the addiction severity index. Journal of Substance Abuse Treatment, 9(3), 199–213. doi:10.1016/0740-5472(92)90062-S.

    PubMed  Article  CAS  Google Scholar 

  • McLellan, A. T., Luborsky, L., Cacciola, J., Griffith, J., Evans, F., Barr, H. L., et al. (1985). New data from the addiction severity index. Reliability and validity in three centers. The Journal of Nervous and Mental Disease, 173(7), 412–423. doi:10.1097/00005053-198507000-00005.

    PubMed  Article  CAS  Google Scholar 

  • Miller, M., Hemenway, D., Bell, N. S., Yore, M. M., & Amoroso, P. J. (2000). Cigarette smoking and suicide: A prospective study of 300, 000 male active-duty army soldiers. American Journal of Epidemiology, 151(11), 1060–1063.

    PubMed  CAS  Google Scholar 

  • Morris, C. D., Giese, A. A., Turnbull, J. J., Dickinson, M., & Johnson-Nagel, N. (2006). Predictors of tobacco use among persons with mental illnesses in a statewide population. Psychiatric Services (Washington, DC), 57(7), 1035–1038. doi:10.1176/appi.ps.57.7.1035.

    Google Scholar 

  • National Cancer Institute. (1999). Health effects of exposure to environmental tobacco smoke: The report of the California environmental protection agency. Smoking and tobacco control monograph no. 10. Bethesda, MD: US Department of Health and Human Services, National Institutes of Health, National Cancer Institute.

    Google Scholar 

  • Norman, G. J., Ribisl, K. M., Howard-Pitney, B., & Howard, K. A. (1999). Smoking bans in the home and car: Do those who really need them have them? Preventive Medicine, 29(6), 581–589. doi:10.1006/pmed.1999.0574.

    PubMed  Article  CAS  Google Scholar 

  • Okoli, C. T. C., Hall, L. A., Rayens, M. K., & Hahn, E. J. (2007a). Measuring tobacco smoke exposure among smoking and nonsmoking bar and restaurant workers. Biological Research for Nursing, 9(1), 81–89. doi:10.1177/1099800407300852.

    PubMed  Article  CAS  Google Scholar 

  • Okoli, C. T. C., Rayens, M. K., & Hahn, E. J. (2007b). Behavioral effects of nicotine exposure from secondhand tobacco smoke among bar and restaurant workers. Addictive Behaviors, 32(9), 1922–1928. doi:10.1016/j.addbeh.2006.12.013.

    PubMed  Article  Google Scholar 

  • Okoli, C. T. C., Richardson, C. G., Ratner, P. A., & Johnson, J. L. (2008). An examination of the smoking identities and taxonomies of smoking behaviour of youth. Tobacco Control, 17(3), 151–158. doi:10.1136/tc.2007.021683.

    PubMed  Article  CAS  Google Scholar 

  • Ostacher, M. J., Nierenberg, A. A., Perlis, R. H., Eidelman, P., Borrelli, D. J., Tran, T. B., et al. (2006). The relationship between smoking and suicidal behavior, comorbidity, and course of illness in bipolar disorder. The Journal of Clinical Psychiatry, 67(12), 1907–1911.

    PubMed  Article  Google Scholar 

  • Otsuka, R., Watanabe, H., Hirata, K., Tokai, K., Muro, T., Yoshiyama, M., et al. (2001). Acute effects of passive smoking on the coronary circulation in healthy young adults. Journal of the American Medical Association, 286(4), 436–441. doi:10.1001/jama.286.4.436.

    PubMed  Article  CAS  Google Scholar 

  • Patten, C. A., Martin, J. E., & Owen, N. (1996). Can psychiatric and chemical dependency treatment units be smoke free? Journal of Substance Abuse Treatment, 13(2), 107–118. doi:10.1016/0740-5472(96)00040-2.

    PubMed  Article  CAS  Google Scholar 

  • Pickett, M. S., Schober, S. E., Brody, D. J., Curtin, L. R., & Giovino, G. A. (2006). Smoke-free laws and secondhand smoke exposure in US non-smoking adults, 1999–2002. Tobacco Control, 15(4), 302–307. doi:10.1136/tc.2005.015073.

    PubMed  Article  Google Scholar 

  • Pilkington, P. A., Gray, S., & Gilmore, A. (2007). Health impacts of exposure to second hand smoke (SHS) amongst a highly exposed workforce: Survey of London casino workers. BMC Public Health, 7(147), 257. doi:10.1186/1471-2458-7-257.

    PubMed  Article  Google Scholar 

  • Pilkington, P. A., Gray, S., Gilmore, A. B., & Daykin, N. (2006). Attitudes towards second hand smoke amongst a highly exposed workforce: Survey of London casino workers. Journal of Public Health, 28(2), 104–110. doi:10.1093/pubmed/fdi086.

    PubMed  Article  CAS  Google Scholar 

  • Pirkle, J. L., Bernert, J. T., Caudill, S. P., Sosnoff, C. S., & Pechacek, T. F. (2006). Trends in the exposure of nonsmokers in the U.S. population to secondhand smoke: 1988–2002. Environmental Health Perspectives, 114(6), 853–858.

    PubMed  CAS  Google Scholar 

  • Pitsavos, C., Panagiotakos, D. B., Chrysohoou, C., Skoumas, J., Tzioumis, K., Stefanadis, C., et al. (2002). Association between exposure to environmental tobacco smoke and the development of acute coronary syndromes: The CARDIO2000 case-control study. Tobacco Control, 11(3), 220–225. doi:10.1136/tc.11.3.220.

    PubMed  Article  CAS  Google Scholar 

  • Pope, C. A., Burnett, R. T., Thun, M. J., Calle, E. E., Krewski, D., Ito, K., et al. (2002). Lung cancer, cardiopulmonary mortality, and long-term exposure to fine particulate air pollution. Journal of the American Medical Association, 287(9), 1132–1141. doi:10.1001/jama.287.9.1132.

    PubMed  Article  CAS  Google Scholar 

  • Prescott, S. L. (2008). Effects of early cigarette smoke exposure on early immune development and respiratory disease. Paediatric Respiratory Reviews, 9(1), 3–10. doi:10.1016/j.prrv.2007.11.004.

    PubMed  Article  Google Scholar 

  • Prochaska, J. J., Fletcher, L., Hall, S. E., & Hall, S. M. (2006). Return to smoking following a smoke-free psychiatric hospitalization. The American Journal on Addictions, 15(1), 15–22. doi:10.1080/10550490500419011.

    PubMed  Article  Google Scholar 

  • Rothberg, M., Heloma, A., Svinhufvud, J., Kahkonen, E., & Reijula, K. (1998). Measurement and analysis of nicotine and other VOCs in indoor air as an indicator of passive smoking. The Annals of Occupational Hygiene, 42(2), 129–134.

    PubMed  Article  CAS  Google Scholar 

  • Ruggeri, M., Leese, M., Thornicroft, G., Bisoffi, G., & Tansella, M. (2000). Definition and prevalence of severe and persistent mental illness. The British Journal of Psychiatry, 177(2), 149–155. doi:10.1192/bjp.177.2.149.

    PubMed  Article  CAS  Google Scholar 

  • Sargent, R. P., Shepard, R. M., & Glantz, S. A. (2004). Reduced incidence of admissions for myocardial infarction associated with public smoking ban: Before and after study. British Medical Journal, 328(7446), 977–980. doi:10.1136/bmj.38055.715683.55.

    PubMed  Article  Google Scholar 

  • Stamatakis, K. A., Brownson, R. C., & Luke, D. A. (2002). Risk factors for exposure to environmental tobacco smoke among ethnically diverse women in the United States. Journal of Women’s Health & Gender-Based Medicine, 11(1), 45–51. doi:10.1089/152460902753473453.

    Article  Google Scholar 

  • Travers, M. J., Cummings, A., Hyland, A., Repace, J., Babb, S., Pechacek, T., et al. (2004). Indoor air quality in hospitality venues before and after implementation of a clean indoor air law - Westeren New York, 2003. Morbidity and Mortality Weekly Report, 53(44), 1038–1041.

    Google Scholar 

  • U.S. Department of Health and Human Services. (2006). The health consequences of involuntary exposure to tobacco smoke : A report of the surgeon general. Atlanta, Ga: Centers for Disease Control and Prevention, Coordinating Center for Health Promotion, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health.

    Google Scholar 

  • Waxmonsky, J. A., Thomas, M. R., Miklowitz, D. J., Allen, M. H., Wisniewski, S. R., Zhang, H., et al. (2005). Prevalence and correlates of tobacco use in bipolar disorder: data from the first 2000 participants in the systematic treatment enhancement program. General Hospital Psychiatry, 27(5), 321–328. doi:10.1016/j.genhosppsych.2005.05.003.

    PubMed  Article  Google Scholar 

  • Whitlock, G., MacMahon, S., Vander Hoorn, S., Davis, P., Jackson, R., & Norton, R. (1998). Association of environmental tobacco smoke exposure with socioeconomic status in a population of 7725 New Zealanders. Tobacco Control, 7(3), 276–280.

    PubMed  Article  CAS  Google Scholar 

  • Williams, J. M., & Ziedonis, D. (2004). Addressing tobacco among individuals with a mental illness or an addiction. Addictive Behaviors, 29(6), 1067–1083. doi:10.1016/j.addbeh.2004.03.009.

    PubMed  Article  Google Scholar 

  • Yolton, K., Dietrich, K., Auinger, P., Lanphear, B. P., Hornung, R., Lanphear, B. P., et al. (2005). Exposure to environmental tobacco smoke and cognitive abilities among U.S.children and adolescents. Environmental Health Perspectives, 113(1), 98–103.

    PubMed  CAS  Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. NEXUS, University of British Columbia, 302-6190 Agronomy Rd, Vancouver, BC, V6T 1Z3, Canada

    Chizimuzo T. C. Okoli, Joy L. Johnson & Leslie Malchy

  2. British Columbia Centre of Excellence for Women’s Health (BCCEWH), Vancouver, BC, Canada

    Chizimuzo T. C. Okoli

  3. Nursing & Health Behaviour Research Unit, School of Nursing, University of British Columbia, Vancouver, BC, Canada

    Joy L. Johnson & Leslie Malchy

Authors
  1. Chizimuzo T. C. Okoli
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Joy L. Johnson
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Leslie Malchy
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Chizimuzo T. C. Okoli.

Rights and permissions

Reprints and Permissions

About this article

Cite this article

Okoli, C.T.C., Johnson, J.L. & Malchy, L. Correlates of Secondhand Tobacco Smoke Exposure Among Persons with Severe and Persistent Mental Illness (SPMI) Accessing Community Mental Health Services. Community Ment Health J 45, 188–198 (2009). https://doi.org/10.1007/s10597-009-9180-0

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10597-009-9180-0

Keywords

  • Secondhand tobacco smoke exposure
  • Mental illness
  • Community mental health
  • Tobacco use and mental illness