Perceived stress and willingness to quit smoking among patients with depressive and anxiety disorders seeking treatment

Bayan Zaid Fatani; Huda Al-Yahyawi; AbdulAziz Raggam; Mutaz Al-Ahdal; Sukaina Alzyoud; Ahmed N Hassan

doi:10.1002/hsr2.503

Perceived stress and willingness to quit smoking among patients with depressive and anxiety disorders seeking treatment

Health Sci Rep. 2022 Feb 24;5(2):e503. doi: 10.1002/hsr2.503. eCollection 2022 Mar.

Authors

Bayan Zaid Fatani¹, Huda Al-Yahyawi², AbdulAziz Raggam³, Mutaz Al-Ahdal², Sukaina Alzyoud⁴, Ahmed N Hassan^{2

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Affiliations

¹ Department of Psychiatry King AbdulAziz Medical City Jeddah Saudi Arabia.
² Department of Medicine, Psychiatry Division King AbdulAziz University Jeddah Saudi Arabia.
³ Faculty of Medicine University of Jeddah Jeddah Saudi Arabia.
⁴ Department of Community and Mental Health Nursing The Hashemite University Zarqa Jordan.
⁵ Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health Toronto Ontario Canada.
⁶ Department of Psychiatry University of Toronto Toronto Ontario Canada.
⁷ Departments of Pharmacology and Toxicology University of Toronto Toronto Canada.
⁸ Institute of Medical Sciences, University of Toronto Toronto Ontario Canada.

Abstract

Rationale and objectives: Little are known about nicotine dependence (ND), perceived stress, and willingness to quit smoking at different treatment stages in patient with affective disorders (AD). This study aimed to evaluate the association between ND and perceived stress among patients with AD presenting with psychiatric treatment at different clinical stages (first visit or follow-up), and in different nicotine type users (cigarette and waterpipe smokers). We also aimed to evaluate the willingness to quit smoking and its association with barriers to quitting.

Methods: This cross-sectional mixed-method study collected quantitative and qualitative data from patients (n = 57) presenting for treatment with AD and ND at different sites in Saudi Arabia. Quantitative validated scales were used to assess the 70 of depression symptoms, anxiety symptoms, perceived stress, and ND. Qualitative questions assessed barriers to quit smoking. We used a linear regression modeling to estimate the association between ND and perceived stress as well as to estimate the association between barrier to quit and willingness to quit.

Results: ND had a statistically significant association with perceived stress (odds ratio [OR]: 2.09; 95% confidence interval [CI]: 1.20-3.63). Participants in the follow-up group had a higher ND score than those in the first-visit group. One of the most commonly reported barriers to quitting was using nicotine as a stress management (33.3%), which predicted positive willingness to quit (OR: 2.23; 95% CI: 1.48-3.37; P < .01). Boredom was reported as a barrier in the waterpipe group more than cigarette group.

Conclusion: ND has a significant association with perceived stress regardless of treatment status in patients with AD, indicating the need to evaluate smoking cessation during the early stages of treatment for patients with AD and ND. It will be critical for clinicians to offer patients with AD alternative coping mechanisms to manage stress and boredom.

Keywords: anxiety; depression; nicotine dependence; smoking; stress; waterpipe; willingness.