Assessment of tobacco and substance use among patients with aluminum phosphide poisoning: A register-based study

Aluminum phosphide (AlP) poisoning is a major public health concern in several low- and middle-income countries due to its high fatality rate and widespread availability. While its clinical toxicity is well-documented, limited research exists on behavioral risk factors such as tobacco and illicit drug use among affected individuals. This study aimed to assess the prevalence of tobacco and substance use among patients with AlP poisoning and explore its associations with demographic characteristics, clinical outcomes, and mortality. A descriptive cross-sectional study was conducted at Razi Hospital in northern Iran between March 2018 and March 2022. Data from 481 AlP poisoning cases were retrospectively analyzed using structured questionnaires, medical records, and interviews. Sociodemographic variables, substance use history, and clinical outcomes were assessed. Of the 481 patients, 29.7% (n = 143) reported tobacco or illicit substance use. Substance use was significantly more prevalent among males (92.3%), individuals aged 21–40, the self-employed, singles, and those with economic hardship or concurrent alcohol consumption (P < 0.05). Although not statistically significant (P = 0.132), mortality was higher among substance users (46.2%) compared to non-users (38.8%). Tobacco and illicit drug use are common among AlP poisoning patients and are strongly associated with specific sociodemographic factors. Although causality could not be established, substance use may contribute to poorer clinical outcomes. These findings underscore the importance of integrating behavioral screening into AlP poisoning management and highlight the need for targeted prevention strategies in high-risk populations.