title: The association between failed quit attempts and increased levels of psychological distress in smokers in a large New Zealand cohort.
abstract: BACKGROUND
  Although the association between smoking status and poorer mental health has been well documented, the association between quit status and psychological distress is less clear. The aim of the present study is to investigate the association of smoking status and quit status with psychological distress.
  
  
  METHODS
  Data for this study is from a single year of the Survey of Families, Income and Employment (SoFIE) conducted in New Zealand (2004/05) (n = 18,525 respondents). Smoking status and quit status were treated as exposure variables, and psychological distress (Kessler-10) was treated as the outcome variable. Logistic regression analyses were performed to determine the association of smoking with psychological distress in the whole adult population and quit status with psychological distress in the ex- and current-smoking population.
  
  
  RESULTS
  Current smokers had higher rates of high and very high psychological distress compared to never smokers (adjusted odds ratio (aOR) = 1.45; 95% CI: 1.24-1.69). Unsuccessful quitters had much higher levels of high to very high levels of psychological distress (16%) than any other group. Moreover, compared to long-term ex-smokers, unsuccessful quitters had a much higher odds of high to very high levels of psychological distress (aOR = 1.73; 95% CI: 1.36-2.21).
  
  
  CONCLUSIONS
  These findings suggest that the significant association between smoking and psychological distress might be partly explained by increased levels of psychological distress among current smokers who made a quit attempt in the last year. This issue needs further study as it has implications for optimising the design of quitting support.
authors.affiliation: Health Inequalities Research Programme, Department of Public Health, University of Otago, Wellington, PO Box 7343, Wellington South 6242, New Zealand.
authors.forename: Frederieke S
authors.initials: FS
authors.lastname: van der Deen
authors.forename: Kristie N
authors.initials: KN
authors.lastname: Carter
authors.forename: Nick
authors.initials: N
authors.lastname: Wilson
authors.forename: Sunny
authors.initials: S
authors.lastname: Collings
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009520:New Zealand; D016540:Smoking Cessation / Q000523:psychology*; D013315:Stress, Psychological; D055815:Young Adult