Cigarette Smoking, Mental Health and Social Support

By Daniel, Mark; Cargo, Margaret D. et al. | Canadian Journal of Public Health, January/February 2004 | Go to article overview

Cigarette Smoking, Mental Health and Social Support


Daniel, Mark, Cargo, Margaret D., Lifshay, Julie, Green, Lawrence W., Canadian Journal of Public Health


Data from a Northwestern First Nation

ABSTRACT

Background: The prevalence of smoking is high in many Aboriginal Canadian communities; rates of 50% are not uncommon. Aboriginal Canadians suffer a severe burden of smoking-related disease. Research in other populations has linked depression and smoking. It is not known whether mental health or affective measures are related to smoking for any of Canada's First Nations, and this study sought to answer this question. Understanding relations between affect and smoking behaviour is requisite to mounting anti-smoking interventions.

Methods: Smoking status and psychosocial measures including depression, mastery, affect balance and social support were obtained in a community-based chronic disease survey for a rural Interior Salishan First Nation in British Columbia (Plateau area). Persons surveyed were on-reserve residents (n=187), overweight (body mass index ≥25 kg/m^sup 2^), with mean age of 44.1 years (standard deviation 15.0).

Results: The prevalence of smoking was 48.1%. Adjusted for age, sex and body mass index, smokers relative to nonsmokers had higher (p<0.010) depression (mean 21.3 [Cl 95%, 19.1-23.4] vs. 16.1 [14.1-18.0]) and negative affect (18.6 [14.9-22.3] vs. 11.0 [7.6-14.4]), and lower mastery (36.4 [35.5-37.3] vs. 38.1 [37.2-38.9]). A positive relationship between mastery and social support was greater for nonsmokers (p=0.046).

Conclusion: Depression and negative affect are associated with smoking among overweight persons in a rural First Nation in British Columbia. Furthermore, smoking is inversely related to mastery, and this relation varies with social support. Longitudinal study is required to determine whether smoking influences mental health and mastery, or the reverse.

RESUME

Contexte : Le tabagisme est tres repandu dans de nombreuses communautes autochtones du Canada; des taux de 50 % ne sont pas rares, et les Autochtones du Canada souffrent beaucoup de maladies liees au tabagisme. Les recherches menees aupres d'autres populations ont etabli un lien entre la depression et le tabagisme. Par ailleurs, on ne sait pas si le tabagisme a une incidence sur la sante mentale ou emotionnelle des Autochtones du Canada. La comprehension des liens entre l'affect et le statut de fumeur est un important prealable a l'elaboration d'interventions visant la reduction du tabagisme.

Methode : Une enquete au niveau communautaire sur les maladies chroniques d'une population rurale autochtone de la Colombie-Britannique a fourni des donnees sur le statut de fumeur/non-fumeur et sur des caracteristiques psychosociales incluant la depression, la maitrise de sa situation, l'equilibre emotif et le soutien social. Les participants de l'etude etaient des Indiens inscrits vivant dans une reserve (n=187), 67 % etant des femmes, et l'age moyen etait de 44,1 ans (ecart-type de 15,0).

Resultats : Le taux de tabagisme etait de 48,1 %. Compte tenu de l'age, du sexe et de l'indice de masse corporelle, les fumeurs, comparativement aux non-fumeurs presentaient des taux plus eleves (p<0,010) de depression (21,3 [19,1-23,4] c. 16,1 [14,1-18,01) et d'affect negatif (18,6 [14,9-22,3] c. 11,0 17,6-14,41), et un taux moins eleve de maitrise de sa situation (36,4 [35,5-37,3] c. 38,1 [37,2-38,9]). Une relation positive entre la maitrise de sa situation et des niveaux superieurs de soutien social prevalait chez les non-fumeurs (p=0,046).

Conclusion : II existe une correlation entre la depression ou un affect negatif et le tabagisme chez les personnes faisant de l'embonpoint dans une population rurale autochtone de la Colombie-Britannique. De plus, le tabagisme est inversement proportionnel a la maitrise de sa situation, et cette relation varie selon le degre de soutien social. Les efforts pour reduire le tabagisme dans la population autochtone du Canada devraient porter sur les aspects de la sante mentale, du soutien social et de la maitrise de sa situation, en tenant compte des contextes socioculturel et historique plus larges d'ou emergent les formes actuelles de style de vie. …

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