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Dr Muhammad Usman Aslam
Dr Kamal Khan Mandokhail
Dr Syed Sofyan Muhammad
Dr Manisha Kumari
Dr Muhammad Usman Siddiqi
Dr Maham Moosani


Addiction, Tobacco, Smoking, Nicotine, Dependence, Depression


Objective: To ascertain the frequency and patterns of nicotine use habits among individuals diagnosed with depression.

Materials and Methods: This descriptive cross-sectional study was carried out at Psychiatry department of Jinnah Post-Graduation Medical Centre Karachi, Pakistan from October 2023 to March 2024. The hospital’s ethical board approval was obtained. The study aimed to assess nicotine use and dependence among 130 depression-diagnosed patients. Data collection utilized semi-structured forms and standardized tools, including the WHO STEPS tool and the simple and modified Fagerstrom Test. IBM-SPSS version 23.0 was used to compute and analyze the data.

Results: The study included 130 participants with Major Depressive Disorder. 61.5% reported tobacco use, with 57.5% smoking only, 15% using nicotine vapes, 18.75% using nicotine douches, and 8.75% using both. Tobacco use was higher among men. 60.8% of tobacco smokers were heavily addicted, along with 83.33% of nicotine vapes users and 85.71% of nicotine douches users. Only 13.75% expressed a strong intention to quit, with a median Quit Smoking Score of 4, suggesting contemplation without concrete plans.

Conclusion: This study underlines the significant occurrence of nicotine use and dependence among individuals with depressive illnesses. Utilizing standardized screening tools in routine clinical practice can aid in timely identification and management of nicotine-use disorder. Integrating these tools into psychiatric patient diagnosis can enhance overall care and outcomes, particularly in countries like Pakistan.

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1. Perez-Warnisher, M. T., De Miguel, M. D. P. C., & Seijo, L. M. (2018). Tobacco Use Worldwide: Legislative Efforts to Curb Consumption. Annals of global health, 84(4), 571–579.
2. J D, N S, Z C, et al. The Tobacco Atlas. 6 ed. Atlanta: American Cancer Society, Inc., 2018
3. Basit, A., Younus, B. B., Waris, N., Fawwad, A., & members NDSP (2020). Prevalence of tobacco use in urban and rural areas of Pakistan; a sub-study from second National Diabetes Survey of Pakistan (NDSP) 2016 - 2017. Pakistan journal of medical sciences, 36(4), 808–815.
4. Richardson, S., McNeill, A., & Brose, L. S. (2019). Smoking and quitting behaviours by mental health conditions in Great Britain (1993-2014). Addictive behaviors, 90, 14–19.
5. Asharani, P. V., Ling Seet, V. A., Abdin, E., Siva Kumar, F. D., Wang, P., Roystonn, K., Lee, Y. Y., Cetty, L., Teh, W. L., Verma, S., Mok, Y. M., Fung, D. S. S., Chong, S. A., & Subramaniam, M. (2020). Smoking and Mental Illness: Prevalence, Patterns and Correlates of Smoking and Smoking Cessation among Psychiatric Patients. International journal of environmental research and public health, 17(15), 5571.
6. Mathew, A. R., Hogarth, L., Leventhal, A. M., Cook, J. W., & Hitsman, B. (2017). Cigarette smoking and depression comorbidity: systematic review and proposed theoretical model. Addiction (Abingdon, England), 112(3), 401–412.
7. Lessov-Schlaggar, C. N., Pergadia, M. L., Khroyan, T. V., & Swan, G. E. (2008). Genetics of nicotine dependence and pharmacotherapy. Biochemical pharmacology, 75(1), 178–195.
8. Hughes J. R. (2011). The hardening hypothesis: is the ability to quit decreasing due to increasing nicotine dependence? A review and commentary. Drug and alcohol dependence, 117(2-3), 111–117.
9. Grunze, A., Mosolov, S., Grunze, H., & Born, C. (2023). The detrimental effects of smoking on the course and outcome in adults with bipolar disorder-A narrative review. Frontiers in psychiatry, 13, 1114432.
10. El-Sherbiny, N. A., & Elsary, A. Y. (2022). Smoking and nicotine dependence in relation to depression, anxiety, and stress in Egyptian adults: A cross-sectional study. Journal of family & community medicine, 29(1), 8–16.
11. Aggarwal DN and Prakash DR. A cross sectional study of prevalence of tobacco use and its correlates in psychiatric in-patients Int J Scientific Res. 7: 4-6
12. Vanable PA, Carey MP, Carey KB and Maisto SA. Smoking among psychiatric outpatients: relationship to substance use, diagnosis, and illness severity. Psychology of addictive behaviors : journal of the Society of Psychologists in Addictive Behaviors. 2003; 17: 259-65
13. Milani HS, Kharaghani R, Safa M, et al. Pattern of smoking and nicotine dependence in patients with psychiatric disorders. Tanaffos. 2012; 11: 55-60.
14. Solty H, Crockford D, White WD and Currie S. Cigarette smoking, nicotine dependence, and motivation for smoking cessation in psychiatric inpatients. Canadian journal of psychiatry Revue canadienne de psychiatrie. 2009; 54: 36-45.