Plurphanswat Nantaporn, Kaestner Robert, Rodu Brad
Research Economist, Brown Cancer Center, University of Louisville, Louisville, KY;, Email:
Professor, Institute of Government and Public Affairs, University of Illinois, Urbana-Champaign, IL.
Am J Health Behav. 2017 Jul 1;41(4):471-483. doi: 10.5993/AJHB.41.4.12.
The disproportionately high smoking prevalence among persons with mental health problems has raised a concern that this population is at increased risk for smoking-related illness. We investigated the effect of smoking on mental health among US adults aged 18 and older using the 2000-2010 Behavioral Risk Factor Surveillance System (BRFSS).
Whereas previous literature has reported a significant association between smoking and mental health, identifying the causal pathway is difficult. To address the plausible reverse causality from mental health to smoking and omitted unobserved factors, we employ the method of instrumental variables (IV) by using state cigarette excise tax as an instrument for smoking.
Our findings show that smoking increases the number of days with poor mental health especially among individuals with more severe illness (more than 14 days in the past month).
Our estimates suggest that smoking causes poor mental health and its effects are concentrated for measures that indicate more severe problems. Public health policies that aim to reduce smoking also may reduce poor mental health.
心理健康问题患者中吸烟率异常高，这引发了人们对该人群吸烟相关疾病风险增加的担忧。我们使用2000 - 2010年行为风险因素监测系统（BRFSS），调查了吸烟对18岁及以上美国成年人心理健康的影响。
尽管先前的文献报道了吸烟与心理健康之间存在显著关联，但确定因果路径很困难。为了解决从心理健康到吸烟可能存在的反向因果关系以及未观察到的遗漏因素，我们采用工具变量法（IV），使用州卷烟消费税作为吸烟的工具变量。
我们的研究结果表明，吸烟会增加心理健康状况不佳的天数，尤其是在病情较重的个体中（过去一个月超过14天）。
我们的估计表明，吸烟会导致心理健康状况不佳，其影响集中在表明更严重问题的指标上。旨在减少吸烟的公共卫生政策也可能减少心理健康问题。
