title: Smoking and mental illness in the U.S. population.
abstract: OBJECTIVE
  Those with any psychiatric diagnosis have substantially greater rates of smoking and are less likely to quit smoking than those with no diagnosis. Using nationally representative data, we sought to provide estimates of smoking and longitudinal cessation rates by specific psychiatric diagnoses and mental health service use.
  
  
  METHODS
  Data were analysed from a two-wave cohort survey of a U.S. nationally representative sample (non-institutionalised adults): the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC; 2001-2002, n=43,093; 2004-2005, n=34,653).
  
  
  METHODS
  We examined smoking rates (lifetime, past year and past year heavy) and cross-sectional quit rates among those with any lifetime or past year psychiatric diagnosis (DSM-IV). Importantly, we examined longitudinal quit rates and conducted analyses by gender and age categories.
  
  
  RESULTS
  Those with any current psychiatric diagnosis had 3.23 (95% CI 3.11 to 3.35) times greater odds of currently smoking than those with no diagnosis, and were 25% less likely to have quit by follow-up (95% CI 20% to 30%). Prevalence varied by specific diagnoses (32.4% to 66.7%) as did cessation rates (10.3% to 17.9%). Comorbid disorders were associated with higher proportions of heavy smoking. Treatment use was associated with greater prevalence of smoking and lower likelihood of cessation.
  
  
  CONCLUSIONS
  Those with psychiatric diagnoses remained much more likely to smoke and less likely to quit, with rates varying by specific diagnosis. Our findings highlight the need to improve our ability to address smoking and psychiatric comorbidity both within and outside of healthcare settings. Such advancements will be vital to reducing mental illness-related disparities in smoking and continuing to decrease tobacco use globally.
authors.affiliation: Epidemiology and Public Health, Yale University, New Haven, Connecticut, USA.
authors.forename: Philip H
authors.initials: PH
authors.lastname: Smith
authors.affiliation: Department of Psychiatry, Yale University School of Medicine, Women's Health Research at Yale, New Haven, Connecticut, USA.
authors.forename: Carolyn M
authors.initials: CM
authors.lastname: Mazure
authors.affiliation: Department of Psychiatry, Yale University School of Medicine, Women's Health Research at Yale, New Haven, Connecticut, USA.
authors.forename: Sherry A
authors.initials: SA
authors.lastname: McKee
mesh_terms: D000293:Adolescent; D000328:Adult; D003430:Cross-Sectional Studies; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D054624:Health Status Disparities; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D001523:Mental Disorders / Q000150:complications* / Q000175:diagnosis; D008605:Mental Health Services / Q000706:statistics & numerical data; D008875:Middle Aged; D015995:Prevalence; D012907:Smoking / Q000453:epidemiology*; D016540:Smoking Cessation / Q000706:statistics & numerical data; D012959:Socioeconomic Factors; D014029:Tobacco Use Disorder / Q000150:complications* / Q000453:epidemiology; D055815:Young Adult
keywords: mental illness; nicotine; psychiatric; smoking; tobacco
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