The Experiences of Patients with Schizophrenia on Smoking and Cessation: A Qualitative Study

Yıl 2024, Cilt: 25 Sayı: 1, 56 - 68, 31.03.2024

Hilal Seki Öz , Şafak Taktak

https://doi.org/10.51982/bagimli.1293514

Öz

Objective: Compared to the general population, patients with schizophrenia have high smoking rates and low smoking cessation rates. The aim of this study was to explore the experiences of patients with schizophrenia regarding smoking and quitting.
Method: The study was carried out based on the phenomenological design, one of the qualitative research methods. Purposeful sampling method was used in the research, and in-depth interviews were conducted with 15 smokers using a semi-structured interview form.
Results: In the thematic analysis, 4 themes, "Effects of schizophrenia", "Coping with smoking", "Factors affecting smoking", "Barriers to quitting smoking" and 13 sub-themes were determined. With the research, it has been seen that those with schizophrenia tend to smoke to cope with the problems caused by the disease, drug treatments, boredom, loneliness and emotional intensity. Some patients are reluctant for smoking cessation, some do not have sufficient motivation and medical support.
Conclusion: In order to prevent the multidimensional problems caused by smoking, it is recommended to conduct intervention studies that enable to manage the factors that increase smoking, strengthen the factors that reduce smoking and encourage smoking cessation.

Anahtar Kelimeler

Schizophrenia, smoking, smoking cessation, qualitative study

Destekleyen Kurum

-

Proje Numarası

-

Teşekkür

The authors are grateful to the patients with schizophrenia who participated in the research.

Şizofreni Hastalarının Sigara İçme ve Sigara Bırakmaya İlişkin Deneyimleri: Nitel Bir Analiz

Öz

Amaç: Şizofreni tanılı hastaların genel nufüsla kıyasladığında sigra içme oranlarının yüksek, sigarayı bırakma oranlarının ise düşük olduğu görülmektedir. Bu çalışma ile şizofreni tanılı hastaların sigara içme ve sigara bırakmaya yönelik deneyimlerini keşfetmek amaçlanmıştır.
Yöntem: Çalışma nitel araştırma yöntemlerinden fenomenolojik desene dayalı olarak gerçekleştirilmiştir. Araştırmada amaçlı örnekleme yöntemi kullanılmış, 15 sigara içen birey ile yarı yapılandırılmış görüşme formu kullanılarak derinlemesine görüşmeler yapılmıştır.
Bulgular: Yapılan tematik analizde 4 tema; “Şizofrenin etkileri”, “Sigara ile baş etme”, “Sigara içmeyi etkileyen faktörler”, “Sigara bırakmaya engeller” ve 13 alt tema belirlenmiştir. Araştırma ile şizofreni tanılı hastaların hastalığın getirdiği sorunlar, ilaç tedavileri, can sıkıntısı, yalnızlık ve duygusal yoğunlukla baş etmek için sigara içmeye yöneldikleri görülmüştür. Bazı hastalar sigarayı bırakmada isteksiz, bazıları yeterli motivasyon ve tıbbi desteğe sahip değildir.
Sonuç: Sigara içmenin getirdiği çok boyutlu sorunları önlemek için sigara içmeyi artıran faktörleri yönetmeyi sağlayan, sigara içmeyi azaltan faktörleri güçlendiren ve sigara bırakmayı teşvik eden müdahale çalışmalarının yapılması önerilir

Anahtar Kelimeler

Şizofreni, sigara içme, sigara bırakma, nitel araştırma

Proje Numarası

-

Kaynakça

• Chesney E, Robson D, Patel R, et al. The impact of cigarette smoking on life expectancy in schizophrenia, schizoaffective disorder and bipolar affective disorder: an electronic case register cohort study. Schizophr Res 2021; 238: 29-35.
• Šagud M, Vuksan-Ćusa B, Jakšić N, et al. Smoking in schizophrenia: an updated review. Psychiatr Danub 2018; 30(Suppl 4): 216-223.
• Dickerson F, Schroeder J, Katsafanas E, et al. Cigarette smoking by patients with serious mental illness, 1999-2016: an increasing disparity. Psychiatr Serv 2018; 69(2): 147-153.
• Caponnetto P, Polosa R, Robson D, et al. Tobacco smoking, related harm and motivation to quit smoking in people with schizophrenia spectrum disorders. Health Psychol Res 2020; 8(1): 9042-9047.
• Huang H, Dong M, Zhang L, et al. Psychopathology and extrapyramidal side effects in smoking and non-smoking patients with schizophrenia: systematic review and meta-analysis of comparative studies. Prog Neuropsychopharmacol Biol Psychiatry 2019; 92: 476-482.
• Seki Öz H, Ayhan D, Taktak Ş. The effect of insight, loneliness, and hope levels on medication adherence in patients with schizophrenia. Perspect Psychiatr Care 2022; 58(4): 2208-2214.
• Ziedonis D, Williams JM, Smelson D. Serious mental illness and tobacco addiction: a model program to address this common but neglected issue. Am J Med Sci 2003; 326(4): 223-230.
• De Oliveira RM, Siqueira Júnior AC, Santos JL, et al. Nicotine dependence in the mental disorders, relationship with clinical indicators, and the meaning for the user. Rev Lat Am Enfermagem 2014; 22(4): 685-692.
• Tomko RL, Saladin ME, Baker NL, et al. Sex differences in subjective and behavioral responses to stressful and smoking cues presented in the natural environment of smokers. Nicotine Tob Res 2020; 22(1): 81-88.
• Mak YW, Chiang VCL, Loke AY. Experiences of tobacco use among chinese ındividuals with schizophrenia in community-based residential settings: a qualitative study. Int J Environ Res Public Health 2020; 17(1): 321-333.
• Pinho S, Rocha V, Vieira-Coelho MA. Effectiveness of multimodal interventions focused on smoking cessation in patients with schizophrenia: a systematic review. Schizophr Res 2021; 231: 145-153.
• Zeng LN, Zong QQ, Zhang L, et al. Worldwide prevalence of smoking cessation in schizophrenia patients: a meta-analysis of comparative and observational studies. Asian J Psychiatr 2020; 54:102190.
• Ding JB, Hu K. Cigarette smoking and schizophrenia: etiology, clinical, pharmacological, and treatment ımplications. Schizophr Res Treatment 2021; 2021:7698030.
• Tong A, Sainsbury P, Craig J. Consolidated criteria for reporting qualitative research (COREQ): a 32-item checklist for interviews and focus groups. Int J Qual Health Care 2007; 19(6): 349-357.
• Baltacı, A. Nitel araştırma süreci: Nitel bir araştırma nasıl yapılır? Ahi Evran Üniversitesi Sosyal Bilimler Enstitüsü Dergisi 2019; 5(2): 368-388.
• Jauhar S, Johnstone M, McKenna PJ. Schizophrenia. Lancet 2022; 399(10323): 473-486.
• Fındıkoğlu S, Doğan S, Özbek H, et al. The effects of music therapy on mood in patients with schizophrenia. JIA Journal 2020; 3(4): 61-70.
• Barron R, Gore JS. The many faces of stress: three factors that predict physical ıllness in young adults. Psychol Rep 2021; 124(3): 1184-1201.
• Ran MS, Wong YI, Yang SY, et al. Marriage and outcomes of people with schizophrenia in rural China: 14-year follow-up study. Schizophr Res 2017; 182: 49-54.
• Gök FA, Ölmez Ş. A qualitative research for the life experiences of wives and men who have a diagnosis of schizophrenia. Journal of Society & Social Work 2021; 32(1): 41-57.
• Kaya Y, Öz F. Global social functioning of patients with schizophrenia and care burden of caregiving relatives. J Psychiatric Nurs 2019; 10(1): 28-38.
• Peng MM, Xing J, Tang X, et al. Disease-related risk factors for caregiver burden among family caregivers of persons with schizophrenia: a systematic review and meta-analysis. Int J Environ Res Public Health 2022; 19(3): 1862-1878.
• Allen MH, Debanné M, Lazignac C, et al. Effect of nicotine replacement therapy on agitation in smokers with schizophrenia: a double-blind, randomized, placebo-controlled study. Am J Psychiatry 2011; 168(4): 395-399.
• Schröder R, Reuter M, Faßbender K, et al. The role of the SLC6A3 3' UTR VNTR in nicotine effects on cognitive, affective, and motor function. Psychopharmacology (Berl) 2022; 239(2): 489-507.
• Wang Q, Zhu X, Jiang X, et al. Relationship between stressful life events, coping styles, and schizophrenia relapse. Int J Ment Health Nurs 2021; 30(5): 1149-1159.
• Cooper J, Mancuso SG, Borland R, et al. Tobacco smoking among people living with a psychotic illness: the second Australian survey of psychosis. Aust N Z J Psychiatry 2012; 46(9): 851-863.
• Saha S, Chant D, McGrath J. A systematic review of mortality in schizophrenia: is the differential mortality gap worsening over time? Arch Gen Psychiatry 2007; 64(10): 1123-1131.
• Steinberg ML, Williams JM, Ziedonis DM. Financial implications of cigarette smoking among individuals with schizophrenia. Tob Control 2004; 13(2): 206-208.
• Keltner NL, Grant JS. Smoke, smoke, smoke that cigarette. Perspect Psychiatr Care 2006;42(4):256-261.
• Pereira MO, Assis BCS, Gomes NMR, et al. Motivation and difficulties to reduce or quit smoking. Rev Bras Enferm 2020; 73(1): e20180188.
• Lum A, Skelton E, Wynne O, et al. A systematic review of psychosocial barriers to smoking cessation in people living with schizophrenia. Front Psychiatry 2018; 9:565.1-17.
• Twyman L, Bonevski B, Paul C, et al. Perceived barriers to smoking cessation in selected vulnerable groups: a systematic review of the qualitative and quantitative literature. BMJ Open 2014; 4(12): 1-15.
• Anthenelli RM, Benowitz NL, West R, et al. Neuropsychiatric safety and efficacy of varenicline, bupropion, and nicotine patch in smokers with and without psychiatric disorders (EAGLES): a double-blind, randomised, placebo-controlled clinical trial. Lancet 2016; 387(10037): 2507-2520.
• Vural F, Köroğlu MA. Social life and social work relationship of schizophrenic patients: Kütahya sample. Optimum Journal of Economics and Management Sciences 2020; 7(2): 653-668.
• Hawes MR, Roth KB, Cabassa LJ. Systematic review of psychosocial smoking cessation interventions for people with serious mental illness. J Dual Diagn 2021; 17(3): 216-235.
• Thorndike AN, Achtyes ED, Cather C, et al. Weight gain and 10-year cardiovascular risk with sustained tobacco abstinence in smokers with serious mental illness: a subgroup analysis of a randomized trial. J Clin Psychiatry 2016; 77(3): e320-e326.
• Manzella F, Maloney SE, Taylor GT. Smoking in schizophrenic patients: a critique of the self-medication hypothesis. World J Psychiatry 2015; 5(1): 35-46.