Department of Psychology, University of Houston, Houston, TX.
Department of Behavioral Sciences, University of Texas MD Anderson Cancer Center, Houston, TX.
Nicotine Tob Res. 2018 May 3;20(6):707-713. doi: 10.1093/ntr/ntx099.
Decline in smoking in the United States has slowed over the past 25 years. Mental health problems are common among smokers, and may be an impediment to quitting and remaining abstinent. The study investigated the relationship between serious (past-30-day) psychological distress (SPD) and smoking, estimated trends in the prevalence of SPD among current, former, and never smokers in the United States from 2008 to 2014, and investigated whether heterogeneity in these trends varied by sociodemographic characteristics.
Data were drawn from the National Household Survey on Drug Use (NSDUH), an annual cross-sectional study of persons ages 12 and over (N = 270 227). SPD and smoking in the past 30 days were examined using logistic regression models among adults 18 and older. The prevalence of SPD was examined annually among current, former, and never smokers from 2008 to 2014.
SPD increased among smokers in the United States from 2008 to 2014. An increase in SPD was more rapid among non-daily smokers than daily smokers. The prevalence of SPD was higher among younger smokers, those with less formal education and lower annual family income and higher among current smokers than former and never smokers. The relationships between SPD and smoking were stronger among smokers with higher education levels and annual family income.
Our findings suggest an increase in SPD among smokers over time and that as smoking has declined, those with SPD are comprising a greater proportion of the remaining smokers. Results suggest that mental health must be integrated into mainstream tobacco control efforts.
The greater prevalence and increasing rate of Serious Psychological Distress among smokers, relative to former- and never-smokers, from 2008 to 2014 provides support that the greater mental health burden among smokers may be contributing to the slowed reduction in smoking prevalence in the United States. In addition, relationships between SPD and smoking were consistently stronger among smokers with higher levels of education and annual family income. Such results suggest the necessity of incorporating mental health treatments in tobacco use reduction efforts.
在美国，吸烟率在过去 25 年中有所下降。精神健康问题在吸烟者中很常见，可能成为戒烟和保持不吸烟的障碍。本研究调查了严重（过去 30 天）心理困扰（SPD）与吸烟之间的关系，估计了 2008 年至 2014 年期间美国目前、以前和从不吸烟者中 SPD 的流行趋势，并调查了这些趋势的异质性是否因社会人口特征而异。
数据来自国家毒品使用家庭调查（NSDUH），这是一项针对 12 岁及以上人群的年度横断面研究（N=270227）。在 18 岁及以上成年人中，使用逻辑回归模型检查过去 30 天内 SPD 和吸烟情况。2008 年至 2014 年期间，每年检查目前、以前和从不吸烟者中 SPD 的流行率。
美国吸烟者中 SPD 从 2008 年到 2014 年有所增加。与每日吸烟者相比，非每日吸烟者的 SPD 增加速度更快。年轻吸烟者、受教育程度较低、家庭年收入较低以及目前吸烟者的 SPD 患病率较高，而以前和从不吸烟者则较低。SPD 与吸烟之间的关系在受教育程度和家庭年收入较高的吸烟者中更强。
我们的研究结果表明，随着时间的推移，吸烟者的 SPD 有所增加，而且随着吸烟率的下降，患有 SPD 的吸烟者在剩余吸烟者中所占比例越来越大。结果表明，必须将心理健康纳入主流烟草控制工作。
与以前和从不吸烟者相比，2008 年至 2014 年期间，吸烟者中严重心理困扰的患病率和增长率更高，这表明吸烟者的心理健康负担更大，可能是美国吸烟率下降速度放缓的原因之一。此外，SPD 与吸烟之间的关系在受教育程度和家庭年收入较高的吸烟者中始终更强。这些结果表明，在减少烟草使用的努力中，必须纳入心理健康治疗。
