Nicotine dependence and gender differences in smokers accessing community mental health services

Accessible summary • This study explores gender differences in smoking behaviour among individuals accessing community mental health services. • Subjective ratings of tobacco addiction were higher in women than in men, and different variables were associated with nicotine dependence for men and women. • These factors are important for understanding individual differences in tobacco dependence among clients with mental illnesses. Abstract Despite evidence of differences in smoking behaviour between women and men, few studies have assessed these differences in individuals with mental illnesses. In this cross-sectional study, we explored gender differences in smoking behaviour among 298 individuals (60% male) accessing community mental health services. Individuals with a psychotic disorder as compared with a non-psychotic disorder, and individuals using a greater number of substances were more likely to be male. Readiness to change, daily cigarette consumption and level of nicotine dependence did not differ between men and women; however, subjective ratings of tobacco addiction were higher in women than in men. Among women, only scores on the subjective tobacco addiction scale were associated with nicotine dependence, while among men, a variety of variables were associated with nicotine dependence. These factors are important for understanding individual differences in tobacco dependence among clients with mental illnesses, and are expected to inform future studies examining tobacco use in mental health treatment populations.