Background:
Individuals with mental illnesses (MI) are a vulnerable population with high tobacco use and related morbidity and mortality. However, few studies examine factors associated with successful cessation among them. Secondhand smoke exposure (SHSe), for example, is an important predictor of greater nicotine dependence (ND) and poor cessation (SC) outcomes. However, little is known about the impact of SHSe on ND or SC in persons with MI. Hence, the objectives of our study were to:
1) Quantify SHSe in this population and
2) examine its association with ND and SC attempts.

Methods:
A cross-sectional survey (15-20 minutes) was conducted of 118 tobacco-users in an inpatient psychiatric facility. Information on demographics, tobacco use and SHSe history, motivation to quit smoking, ND (on a scale of 0-10), and SC attempts (in the past year) were obtained. Participants' reported environmental (past 7 days), peer and family, and perceived SHSe (scale of 0-10) were described. Multivariate linear regression analyses were used to examine the association between SHSe and ND while logistic regression analysis assessed the associations between SHSe and SC attempts (yes vs. no).

Results:
The primary sources of environmental SHSe were from the car (63.6%) and home (51.7%); primary sources of peer and family SHSe were close friends (67.8%) and parents (65.3%); and the perceived SHSe was a mean score of 6.2 (SD=3.5). Although perceived SHSe was significantly associated with ND (β=.39, p < .0001) in multivariate analyses, no SHSe variables was associated with SC attempts. However, motivation to quit smoking variables were associated with SC attempts.

Conclusions:
Hospitalized patients with MI report high SHSe. Given that SHSe is associated with higher ND in this study, routine screening for SHSe may be incorporated as part of health assessment in this population. In addition, targeted interventions and policies should be examined to reduce SHS in this population.