• Vol. 41 No. 8, 325–334
  • 15 August 2012

Smoking and Nicotine Dependence in Singapore: Findings from a Cross-Sectional Epidemiological Study



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Introduction: Smoking is one of the leading preventable causes of death throughout the world and can lead to nicotine dependence, particularly when initiated at a young age. This paper describes the prevalence of smoking and nicotine dependence in the adult Singapore resident population, whilst also exploring rates among the major ethnic groups (Chinese, Malay and Indian), different education levels and those with chronic psychiatric and physical comorbidities.

Materials and Methods: The Singapore Mental Health Study (SMHS) is a cross-sectional epidemiological study that was conducted between December 2009 and December 2010. Information on smoking status was assessed using the Composite International Diagnostic Interview version 3.0 (CIDI 3.0) and the Fagerstrom Test for Nicotine Dependence measured nicotine dependence. Socio-demographic information was also collected.

Results: In total, 6616 respondents participated in the SMHS giving a response rate of 75.9%. We found that 16% of the population were current smokers and 4.5% had nicotine dependence. Current smokers were more likely to be younger (18 to 34 years old), males, Malay and have lower education, whilst males had a 4.6 times higher risk of nicotine dependence to that of females. The prevalence of nicotine dependence was also higher in those with alcohol abuse and those experiencing chronic pain.

Conclusion: The results from this study highlight the important differences in the prevalence of smoking and nicotine dependence among different age groups, gender and ethnicity in Singapore and are important for developing future health policies and targeted preventive strategies.

Tobacco is the leading cause of preventable death and is the fourth most common risk factor for disease. Nearly 6 million deaths occur worldwide every year, which equates to one death every 6 seconds or one in 10 adult deaths. Cigarette smoke contains over 7000 chemicals and compounds, of which hundreds are toxic and at least 69 are carcinogenic. Nicotine is the key chemical compound that causes and sustains cigarette addiction and the design and contents of tobacco products today have made them more addictive than ever before. Tobacco causes over 20 different diseases, many of which are fatal or disabling. More specifically, it is responsible for over 70% of all lung cancer deaths globally, 42% of respiratory disease deaths and nearly 10% of all cardiovascular disease related deaths.

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