title: Smokers with Self-Reported Mental Health Conditions: A Case for Screening in the Context of Tobacco Cessation Services.
abstract: BACKGROUND
  People with mental health conditions (MHC) smoke at high rates and many die prematurely from smoking-related illnesses. Smoking cessation programs, however, generally do not screen for MHC. This study examined the utility of MHC screening in a large tobacco quitline to determine whether self-reported MHC predicts service utilization and quitting behaviors.
  
  
  RESULTS
  A brief set of question on MHC was embedded in the routine intake of a state quitline, and 125,261 smokers calling from June 2012 to September 2015 were asked the questions. Quit attempt rate and 6-month success rate were analyzed for a random subset of participants. Overall, 52.2% of smokers reported at least one MHC. Demographic patterns like gender or ethnic difference in self-reported MHC were similar to that in the general population. Depression disorder was reported most often (38.6%), followed by anxiety disorder (33.8%), bipolar disorder (17.0%), drug/alcohol abuse (11.9%), and schizophrenia (7.9%). Among those reporting any MHC, about two-thirds reported more than 1 MHC. Smokers with MHC received more counseling than smokers with no MHC. Quit attempt rates were high for all three groups (>70%). The probability of relapse was greater for those with more than one MHC than for those with one MHC (p<0.005), which in turn was greater than those with no MHC (p < .01). The six-month prolonged abstinence rates for the three conditions were, 21.8%, 28.6%, and 33.7%, respectively. The main limitation of this study is the use of a non-validated self-report question to assess MHC, even though it appears to be useful for predicting quitting behavior.
  
  
  CONCLUSIONS
  Smokers with MHC actively seek treatment to quit. Smoking cessation services can use a brief set of questions to screen for MHC to help identify smokers in need of more intensive treatment to quit smoking.
authors.affiliation: Moores Cancer Center, University of California San Diego, La Jolla, California, United States of America.
authors.forename: Gary J
authors.identifier: http://orcid.org/0000-0001-5121-7064
authors.initials: GJ
authors.lastname: Tedeschi
authors.affiliation: Moores Cancer Center, University of California San Diego, La Jolla, California, United States of America.|Department of Family Medicine and Public Health, University of California San Diego, La Jolla, California, United States of America.
authors.forename: Sharon E
authors.identifier: http://orcid.org/0000-0003-3481-8436
authors.initials: SE
authors.lastname: Cummins
authors.affiliation: Moores Cancer Center, University of California San Diego, La Jolla, California, United States of America.
authors.forename: Christopher M
authors.identifier: http://orcid.org/0000-0002-1801-6604
authors.initials: CM
authors.lastname: Anderson
authors.affiliation: Department of Psychiatry, University of California San Diego, La Jolla, California, United States of America.
authors.forename: Robert M
authors.initials: RM
authors.lastname: Anthenelli
authors.affiliation: Moores Cancer Center, University of California San Diego, La Jolla, California, United States of America.
authors.forename: Yue-Lin
authors.identifier: http://orcid.org/0000-0002-2038-9477
authors.initials: YL
authors.lastname: Zhuang
authors.affiliation: Moores Cancer Center, University of California San Diego, La Jolla, California, United States of America.|Department of Family Medicine and Public Health, University of California San Diego, La Jolla, California, United States of America.
authors.forename: Shu-Hong
authors.initials: SH
authors.lastname: Zhu
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000437:Alcoholism / Q000209:etiology; D001714:Bipolar Disorder / Q000209:etiology; D003863:Depression / Q000209:etiology; D005260:Female; D006801:Humans; D008297:Male; D008603:Mental Health; D008875:Middle Aged; D012559:Schizophrenia / Q000209:etiology; D057566:Self Report; D016540:Smoking Cessation / Q000379:methods*; D014029:Tobacco Use Disorder / Q000150:complications* / Q000523:psychology / Q000628:therapy*; D055815:Young Adult