title: Smoking status, nicotine dependence and happiness in nine countries of the former Soviet Union.
abstract: BACKGROUND
  The US Food and Drug Administration has established a policy of substantially discounting the health benefits of reduced smoking in its evaluation of proposed regulations because of the cost to smokers of the supposed lost pleasure they suffer by no longer smoking. This study used data from nine countries of the former Soviet Union (fSU) to explore this association in a setting characterised by high rates of (male) smoking and smoking-related mortality.
  
  
  METHODS
  Data came from a cross-sectional population-based study undertaken in 2010/2011 in Armenia, Azerbaijan, Belarus, Georgia, Kazakhstan, Kyrgyzstan, Moldova, Russia and Ukraine. Information was collected from 18 000 respondents aged ≥18 on smoking status (never, ex-smoking and current smoking), cessation attempts and nicotine dependence. The association between these variables and self-reported happiness was examined using ordered probit regression analysis.
  
  
  RESULTS
  In a pooled country analysis, never smokers and ex-smokers were both significantly happier than current smokers. Smokers with higher levels of nicotine dependence were significantly less happy than those with a low level of dependence.
  
  
  CONCLUSIONS
  This study contradicts the idea that smoking is associated with greater happiness. Moreover, of relevance for policy in the fSU countries, given the lack of public knowledge about the detrimental effects of smoking on health but widespread desire to quit reported in recent research, the finding that smoking is associated with lower levels of happiness should be incorporated in future public health efforts to help encourage smokers to quit by highlighting that smoking cessation may result in better physical and emotional health.
authors.affiliation: European Centre on Health of Societies in Transition, London School of Hygiene and Tropical Medicine, London, UK Stockholm Centre on Health of Societies in Transition (SCOHOST), Södertörn University, Huddinge, Sweden Department of Human Ecology, Graduate School of Medicine, University of Tokyo, Tokyo, Japan.
authors.forename: Andrew
authors.initials: A
authors.lastname: Stickley
authors.affiliation: Research and Development Unit, Parc Sanitari Sant Joan de Déu, Fundació Sant Joan de Déu, Sant Boi de Llobregat, Barcelona, Spain Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental, Cibersam, Spain.
authors.forename: Ai
authors.initials: A
authors.lastname: Koyanagi
authors.affiliation: European Centre on Health of Societies in Transition, London School of Hygiene and Tropical Medicine, London, UK.
authors.forename: Bayard
authors.initials: B
authors.lastname: Roberts
authors.affiliation: Stockholm Centre on Health of Societies in Transition (SCOHOST), Södertörn University, Huddinge, Sweden Department of Epidemiology and Biostatistics, National Institute for Health Development, Tallinn, Estonia.
authors.forename: Mall
authors.initials: M
authors.lastname: Leinsalu
authors.affiliation: Health Economics Group, Norwich Medical School, University of East Anglia, Norwich, UK.
authors.forename: Yevgeniy
authors.initials: Y
authors.lastname: Goryakin
authors.affiliation: European Centre on Health of Societies in Transition, London School of Hygiene and Tropical Medicine, London, UK.
authors.forename: Martin
authors.initials: M
authors.lastname: McKee
mesh_terms: D000293:Adolescent; D000328:Adult; D003430:Cross-Sectional Studies; D005260:Female; D006240:Happiness; D006801:Humans; D008297:Male; D008875:Middle Aged; D009538:Nicotine / Q000009:adverse effects*; D057181:Pleasure; D057566:Self Report; D012907:Smoking / Q000523:psychology*; D016540:Smoking Cessation / Q000523:psychology*; D012959:Socioeconomic Factors; D014029:Tobacco Use Disorder / Q000523:psychology*; D014586:USSR; D055815:Young Adult
chemical_list: D009538:Nicotine
keywords: consumer surplus; happiness; health; nicotine dependence; smoking