Department of Neuropsychiatry, Okayama University Hospital, Okayama, Japan.
Department of Psychiatry, Faculty of Medicine, Shimane University, Izumo, Japan.
J Affect Disord. 2018 Oct 15;239:131-137. doi: 10.1016/j.jad.2018.07.008. Epub 2018 Jul 3.
Smoking behavior among people with serious psychological distress (SPD) has not been fully investigated in Asia, although smoking has become a public health concern worldwide. Many Western population-based studies indicate that people with psychological distress are more likely to smoke.
This study used a national representative data set from the 2010 Comprehensive Survey of Living Conditions of Japan. SPD was defined as scores ≥13 or greater on the Kessler Psychological Distress Scale (K6). Multivariate logistic regression analyses were conducted to analyze the association between SPD and current smoking in Japanese adults.
In both men (n = 27,937) and women (n = 30,786), SPD was significantly associated with current smoking (adjusted odds ratios [95% confidence intervals]: 1.169 [1.030-1.328] for men and 1.677 [1.457-1.931] for women). Among men, SPD was significantly associated with current smoking only in people aged ≥50 years (1.519 [1.232-1.874]) and married (1.456 [1.228-1.728]). SPD was significantly associated with current smoking in women of all ages. SPD had a greater impact on current smoking for women aged 20-49 years than for those aged ≥50 years (1.832 [1.552-2.162] and 1.445 [1.099-1.900], respectively).
The cross-sectional design precludes assumptions about the direction of causality. In addition, smoking status was self-reported.
SPD was significantly associated with current smoking in Japan and the association was much stronger for younger women. Clinical strategies are needed to reduce the prevalence of smoking among people with SPD to reduce excess mortality in this population.
尽管吸烟已成为全球关注的公共卫生问题，但在亚洲，针对有严重心理困扰（SPD）人群的吸烟行为尚未得到充分研究。许多西方基于人群的研究表明，有心理困扰的人更有可能吸烟。
本研究使用了来自 2010 年日本综合生活状况调查的全国代表性数据集。SPD 定义为 Kessler 心理困扰量表（K6）得分≥13 或更高。对日本成年人 SPD 与当前吸烟之间的关联进行了多变量逻辑回归分析。
男性（n=27937）和女性（n=30786）中，SPD 与当前吸烟显著相关（调整后的优势比[95%置信区间]：男性为 1.169 [1.030-1.328]，女性为 1.677 [1.457-1.931]）。在男性中，SPD 仅与≥50 岁（1.519 [1.232-1.874]）和已婚人群（1.456 [1.228-1.728]）中的当前吸烟者显著相关。SPD 与所有年龄段的女性当前吸烟者显著相关。SPD 对 20-49 岁女性当前吸烟的影响大于≥50 岁女性（分别为 1.832 [1.552-2.162]和 1.445 [1.099-1.900]）。
横断面设计排除了关于因果关系方向的假设。此外，吸烟状况是自我报告的。
SPD 与日本的当前吸烟显著相关，且这种关联在年轻女性中更为强烈。需要采取临床策略来降低 SPD 人群的吸烟率，以减少该人群的超额死亡率。
