Smoking and Mental Illness

TLDR

Smoking is the leading preventable cause of death in the U.S., and persons with mental illness exhibit markedly higher smoking rates and greater difficulty quitting, warranting focused public health attention. The study aimed to determine whether individuals with mental illness smoke more, quit less, and represent a substantial share of the U.S. tobacco market using nationally representative data.

Abstract

THE LEADING PREventable cause of death in the United States. 1 In an effort to target public health interventions, recent studies have focused on smoking in distinct populations, such as pregnant women 2 and adolescents. 3e believe those with mental illness are another group that merits special attention.Previous studies have found high smoking rates among selected populations of persons with mental illness, such as psychiatric outpatients 4 and patients in a state mental hospital. 5][8][9][10][11] Persons with mental illness may encounter greater difficulty with tobacco cessation. 4,12,13However, no recent study has analyzed rates of smoking and quit rates across the spectrum of psychiatric diagnoses in a nationally representative sample.We hypothesized that persons with mental illness smoke at higher rates than persons without mental illness, have lower quit rates, and comprise a large proportion of the US tobacco market.We used population-based data from the National Comorbidity Survey 14 (NCS) to examine the association between type and severity of mental illness and the likelihood of smoking and subsequent cessation.The NCS differed from previous studies because it was the first to administer a structured psychiatric interview to a nationally representative sample. 15Furthermore, the NCS was specifically designed to examine both substance-use and nonsubstance-use psychiatric disorders. METHODS Data SourcesThe NCS was a congressionally mandated study of the prevalence of psychiatric disorders in the United States. 15dministered between September 1990 and February 1992, the survey used a stratified, multistage probability sample of persons aged 15 to 54 years in the noninstitutionalized civilian population.The data were released for public use in 1998.The study design allowed for estimation of the national prevalence of mental illness as defined by the Diagnostic and Statistical Manual of Mental Disorders, Third Edition, Revised (DSM-III-R).