Objectives: Tobacco use among individuals with schizophrenia is a pressing concern, and the relationship between nicotine dependence and symptomatology is multifaceted. This study aimed to assess the patterns of nicotine use among patients with schizophrenia in India and validate tobacco use through urinary cotinine levels. Material and Methods: This hospital-based cross-sectional study collected sociodemographic data, nicotine dependence severity, and evaluated symptom severity using standardized instruments. Urinary cotinine levels were measured to validate self-reported tobacco use. Results: Among the 170 male schizophrenia patients studied, 75 fulfilled the inclusion criteria. A substantial proportion was unemployed (72%) and urban residents (60%). Smoking emerged as the predominant form of tobacco use (40%), followed by smokeless tobacco (35%), and 25% used both. Significant positive correlations were observed between the severity of nicotine dependence, assessed by modified Fagerstrom test for nicotine dependence (mFTND) scores, and symptomatology, as measured by positive and negative syndrome scale rating criteria, positive (r = 0.35, p < 0.007) and negative (r = 0.3, p < 0.021) scores. Urinary cotinine levels exhibited a strong positive correlation with mFTND scores (r = 0.53, p < 0.001). It validated the reliability of self-reported tobacco use through significant correlations with urinary cotinine levels, bolstering their utility in clinical assessments. Conclusion: This study highlights the prevalence of tobacco use among patients with schizophrenia in India. The positive correlation between nicotine dependence severity and symptomatology highlights the intricate relationship between tobacco use and schizophrenia. The validation of self-reported tobacco use through urinary cotinine levels enhances the credibility of such assessments in clinical practice. Addressing nicotine dependence within this population is imperative for comprehensive schizophrenia treatment.
Sharma et al. (Fri,) studied this question.