Office of the Assistant Secretary for Planning and Evaluation, US Department of Health and Human Services, Washington, DC, USA.
Portland, Oregon, USA.
Addiction. 2023 Feb;118(2):353-364. doi: 10.1111/add.16052. Epub 2022 Nov 16.
To estimate recent trends in cigarette use and health insurance coverage for United States adults with and without mental health and substance use disorders (MH/SUD).
Event study analysis of smoking and insurance coverage trends among US adults with and without MH/SUD using 2008-19 public use data from the National Survey on Drug Use and Health, an annual, cross-sectional survey.
USA.
A nationally representative sample of non-institutionalized respondents aged 18-64 years (n = 448 762).
Outcome variables were three measures of recent cigarette use and one measure of past-year health insurance coverage. We compared outcomes between people with and without MH/SUD (MH disorder: past-year mental illness, predicted from Kessler-6 and the World Health Organization-Disability Assessment Schedule impairment scale; SUD: met survey-based DSM-IV criteria for past-year alcohol, cannabis, cocaine or heroin use disorder) and over time.
Comparing pooled data from 2008 to 2009 and from 2018 to 2019, current smoking rates of adults with MH/SUD decreased from 37.9 to 27.9% while current smoking rates of adults without MH/SUD decreased from 21.4 to 16.3%, a significant difference in decrease of 4.9 percentage points (pts) [95% confidence interval (CI) = 3.3-6.6 pts]. Daily smoking followed similar patterns (difference in decrease of 3.9 pts (95% CI = 2.3-5.4 pts). Recent smoking abstinence rates for adults with MH/SUD increased from 7.4 to 10.9%, while recent smoking abstinence rates for adults without MH/SUD increased from 9.6 to 12.0%, a difference in increase of 1.0 pts (95% CI = -3.0 to 0.9 pts). In 2018-19, 11% of net reductions in current smoking, 12% of net reductions in daily smoking and 12% of net increases in recent smoking abstinence coincided with greater gains in insurance coverage for adults with MH/SUD compared to those without MH/SUD.
Improvements in smoking and abstinence outcomes for US adults with mental health and substance use disorders appear to be associated with increases in health insurance coverage.
评估美国有心理健康和物质使用障碍（MH/SUD）和无心理健康和物质使用障碍的成年人最近的吸烟趋势和医疗保险覆盖范围。
利用 2008-19 年全国药物使用和健康调查的公共使用数据，对有和无 MH/SUD 的美国成年人的吸烟和保险覆盖趋势进行事件研究分析，这是一项年度横断面调查。
美国。
年龄在 18-64 岁的非机构化受访者的全国代表性样本（n=448762）。
结果变量是最近吸烟的三个衡量标准和过去一年医疗保险覆盖的一个衡量标准。我们比较了有和无 MH/SUD 的人的结果（MH 障碍：过去一年的精神疾病，由 Kessler-6 和世界卫生组织残疾评估量表预测；SUD：过去一年符合基于 DSM-IV 的酒精、大麻、可卡因或海洛因使用障碍的调查标准），并随时间进行比较。
比较 2008 年至 2009 年和 2018 年至 2019 年的 pooled 数据，有 MH/SUD 的成年人的当前吸烟率从 37.9%降至 27.9%，而无 MH/SUD 的成年人的当前吸烟率从 21.4%降至 16.3%，减少幅度有显著差异 4.9 个百分点（95%置信区间[CI]为 3.3-6.6 个百分点）。每日吸烟也呈现类似的模式（减少幅度为 3.9 个百分点[95%CI 为 2.3-5.4 个百分点]）。有 MH/SUD 的成年人最近的吸烟禁欲率从 7.4%增加到 10.9%，而无 MH/SUD 的成年人最近的吸烟禁欲率从 9.6%增加到 12.0%，增加幅度差异为 1.0 个百分点（95%CI 为-3.0 至 0.9 个百分点）。在 2018-19 年，当前吸烟减少的 11%、每日吸烟减少的 12%和最近吸烟禁欲增加的 12%，与 MH/SUD 成年人相比，无 MH/SUD 的成年人的医疗保险覆盖范围的增加幅度更大。
美国有心理健康和物质使用障碍的成年人的吸烟和禁欲结果的改善似乎与医疗保险覆盖范围的增加有关。
