DOI: 10.1192/j.eurpsy.2026.11952 ISSN: 0924-9338

Clinical characteristics of smokers in an international sample of female mental health service users

M. H. Lo, C. T. L. Chan, M. E. S. Reyes, E. S. Jaya, F. Mukhtar, A. E. Z. Lian, G. Derin, P. D. Bengwasan, G. F. Yuan, A. K. C. Chau, S. K. K. Lam, H. W. Fung

Introduction

Smoking is generally associated with mental health issues, but less is known about the relationship of smoking with different specific psychiatric symptoms in clinical samples across cultures.

Objectives

This study examined the mental health profiles of current smokers in an international sample of female mental health service users.

Methods

We analyzed data from the International Female Mental Health Project, in which 995 female mental health service users from around the world completed an online survey. The survey included the Childhood Trauma Section of the Brief Betrayal Trauma Survey, the Patient Health Questionnaire (PHQ-9), the Somatic Symptom Scale-8 (SSS-8), the International Trauma Questionnaire, the Multiscale Dissociation Inventory, and the Screen for Disordered Eating.

Results

Approximately 12.5% of participants reported themselves as current smokers. Compared to non-smokers, smokers were significantly more likely to report childhood trauma (90.2% vs 96.8%), χ² = 5.69, p = .017, score 15 or above on the PHQ-9 (36.4% vs 50.8%), χ² = 9.55, p = .002, score 13 or above on the SSS-8 (52.7% vs 70.2%), χ² = 13.37, p < .001, screen positive for ICD-11 PTSD/CPTSD (45.8% vs 56.5%), χ² = 4.93, p = .026, and screen positive for dissociative symptoms (39.2% vs 54.0%), χ² = 9.94, p = .002. The two groups did not significantly differ in the rate of probable eating disorders (p = .067).

Conclusions

This study provides updated and cross-cultural data showing that smoking is associated with a wide range of mental health symptoms among female mental health service users. Female mental health service users who smoke have a more severe and complex clinical profiles with more comorbidities, and therefore they may require additional clinical care. Prevention and timely management of smoking in mental health settings are important.

Disclosure of Interest

None Declared

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