Social networks of people with serious mental illness who smoke: potential role in a smoking cessation intervention

Abstract

Background

Smoking is a major contributor to morbidity and mortality among individuals with serious mental illness (SMI) and social networks may play an important role in smoking behaviors.

Aims

Our objectives were to (1) describe the network characteristics of adults with SMI who smoke tobacco (2) explore whether network attributes were associated with nicotine dependence.

Methods

We performed a secondary analysis of baseline data from a tobacco smoking cessation intervention trial among 192 participants with SMI. A subgroup (n = 75) completed questions on the characteristics of their social network members. The network characteristics included network composition (e.g. proportion who smoke) and network structure (e.g. density of connections between members). We used multilevel models to examine associations with nicotine dependence.

Results

Participant characteristics included: a mean age 50 years, 49% women, 48% Black, and 41% primary diagnosis of schizophrenia/schizoaffective disorder. The median personal network proportion of active smokers was 22%, active quitters 0%, and non-smokers 53%. The density of ties between actively smoking network members was greater than between non-smoking members (55% vs 43%, p = .02). Proportion of network smokers was not associated with nicotine dependence.

Conclusions

We identified potential social network challenges and assets to smoking cessation and implications for network interventions among individuals with SMI.

Keywords:

• Tobacco smoking
• smoking cessation, mental disorders
• social network analysis

Acknowledgements

The authors would like to thank the trial participants, the Community Advisory Board, and others in the SMI community who made this work possible.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

This study was supported by the Johns Hopkins ALACRITY Center for Health and Longevity in Mental Illness under grant [P50MH115842]. Research reported in this publication was supported by the National Heart, Lung, and Blood Institute of the National Institutes of Health under grant [K23HL116601]. Benjamin Meza was supported by a training grant through the National Heart, Lung, and Blood Institute (NHLBI) of the National Institutes of Health under grant [5T32 HL007180-43]. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. We would like to acknowledge technical support for the statistical analysis from the National Center for Research Resources and the National Center for Advancing Translational Sciences (NCATS) of the National Institutes of Health through grant number [1UL1TR001079].