Factors Associated with the Initial Sensations of Smoking among Smokers with Mental Illness.

People with mental illnesses (MI) have a disproportionate smoking prevalence and associated disease burden. Smoking initiation among people with MI is poorly understood. However, the sensations experienced during smoking initiation predict continued smoking and nicotine dependence. Yet, few studies have examined the initial experiences of smoking among people with MI. Thus, the aim of this study was to explore factors associated with the initial sensations of smoking in people with MI. Smokers in an inpatient psychiatric facility (n = 123) were surveyed. Data obtained included information on demographics, smoking and secondhand smoke (SHS) exposure, psychiatric diagnoses, and sensations of initial smoking. Spearman correlations explored associations among initial smoking sensation variables; and binary logistic regression analyses examined the associations between study variables and groupings derived from initial sensations (i.e., "pleasant + buzz," "unpleasant + buzz," and "all" sensations). The most frequently reported initial smoking sensation was feeling dizzy (87%) and there were low to moderate correlations between unpleasant (e.g., cough, sick, nervous) and pleasant (e.g., good, relaxed) sensations. In logistic regression analyses, having higher perceived SHS exposure was significantly associated with the "pleasant + buzz" sensation grouping; and lower past week SHS exposure was associated with the "unpleasant + buzz" sensation grouping; but, no variables were associated with "all" sensation group. Initial smoking sensations are an uncharted avenue of exploration in understanding smoking initiation among people with MI. SHS exposure may be an important factor associated with the report of both unpleasant and pleasant initial sensations. Future studies are needed to further explore initial sensations in relation to the context of smoking initiation among people with MI.