Non-specific psychological distress, smoking status and smoking cessation: United States National Health Interview Survey 2005.

David Lawrence,Francis Mitrou,Stephen R Zubrick

doi:10.1186/1471-2458-11-256

Abstract

BackgroundIt is well established that smoking rates in people with common mental disorders such as anxiety or depressive disorders are much higher than in people without mental disorders. It is less clear whether people with these mental disorders want to quit smoking, attempt to quit smoking or successfully quit smoking at the same rate as people without such disorders.MethodsWe used data from the 2005 Cancer Control Supplement to the United States National Health Interview Survey to explore the relationship between psychological distress as measured using the K6 scale and smoking cessation, by comparing current smokers who had tried unsuccessfully to quit in the previous 12 months to people able to quit for at least 7 to 24 months prior to the survey. We also used data from the 2007 Australian National Survey of Mental Health and Wellbeing to examine the relationship between psychological distress (K6) scores and duration of mental illness.ResultsThe majority of people with high K6 psychological distress scores also meet diagnostic criteria for mental disorders, and over 90% of these people had first onset of mental disorder more than 2 years prior to the survey. We found that people with high levels of non-specific psychological distress were more likely to be current smokers. They were as likely as people with low levels of psychological distress to report wanting to quit smoking, trying to quit smoking, and to have used smoking cessation aids. However, they were significantly less likely to have quit smoking.ConclusionsThe strong association between K6 psychological distress scores and mental disorders of long duration suggests that the K6 measure is a useful proxy for ongoing mental health problems. As people with anxiety and depressive disorders make up a large proportion of adult smokers in the US, attention to the role of these disorders in smoking behaviours may be a useful area of further investigation for tobacco control.

Highlights

It is well established that smoking rates in people with common mental disorders such as anxiety or depressive disorders are much higher than in people without mental disorders
Non-specific psychological distress and duration of anxiety and depressive disorders Because the K6 scale refers to the 30 days prior to the survey, we first examined data from the Australian National Survey of Mental Health and Wellbeing (NSMHWB) to test the relationship between the K6 measure of non-specific psychological distress, ICD-10 mental disorders as identified using the CIDI, and first onset of anxiety or depressive disorders
We found that the distribution of K6 scores in Australia was similar to that found in the US National Health Interview Survey (NHIS), in the higher levels of distress categories (Table 1)

Summary

Introduction

It is well established that smoking rates in people with common mental disorders such as anxiety or depressive disorders are much higher than in people without mental disorders. While there seems general agreement that smoking is more prevalent among people with mental disorders, there is disagreement as to whether people with mental health problems are less likely than those without mental health problems to want to quit smoking or to be able to quit smoking [12,13]. This is of significance for tobacco control policy as there is large public expenditure on a range of measures designed to promote smoking cessation in adults. These measures have rarely been designed for or targeted at people with mental illness in the belief that population-wide strategies are effective in promoting smoking cessation across the whole population [14,15,16]

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