Little is known about the epidemiology of smoking and substance use disorders (SUD) among psychiatric outpatients in south of Tunisia.

Examine the prevalence of smoking and SUD among adult psychiatric outpatients at the regional hospital of Gabes.

A survey was conducted to assess the extent of alcohol abuse, drug abuse and smoking among adult psychiatric outpatients (n=115), with different psychiatric diagnoses (DSM−5), aged over 18 years, following the psychiatric department of the regional hospital of Gabes. Data collection was done through a semi-structured interview with the patient and a family member+review of medical records. SUD was defined as an abuse or dependence to alcohol or drug.

Smokers account for 29.6% of the patients. Smoking was significantly higher in male patients (97.1% vs. 43.2%, P<10⁻³). Compared to nonsmokers, smokers patients had significantly more the diagnosis of schizophrenia (64.7% vs. 35.3%, P=0.004), a higher level of education (52.9% vs. 32.1%, P=0.03), a higher rate of alcohol (14.7% vs. 1.2%, P=0.008) and drug use disorders (8.8% vs. 0%, P=0.02), and a higher rate of relapses (3.5 vs. 2, P=0.004). Alcohol use was noted in 6% of patients and cannabis in 4%. Patients with a SUD had significantly more the diagnosis of schizophrenia (100% vs. 36.2%, P=0.05), a higher rate of smoking (100% vs. 27.7%, P=0.02). Financial situation, education, marital status and age of onset of the disease were not associated with SUD.

Addictive behaviors are prevalent among psychiatric outpatients. This has implications in treatment and management of these patients.