The relationship between nicotine cessation and mental disorders in a nationally representative sample

Abstract

The objective of this study was to examine the relationship between Axis I and II mental disorders, quality of life, and nicotine dependence cessation in a nationally representative sample. Data came from Wave 2 of the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC), a nationally representative survey of adults in the United States (N = 34,653). People who met DSM-IV criteria for nicotine dependence previously but who had abstained from nicotine in the last year (nicotine cessation) were compared to people currently dependent on nicotine as well as lifetime abstainers using multivariate logistic regression. Outcomes of interest included DSM-IV Axis I and II mental disorders, treatment seeking for mental disorders, and quality of life measures. In adjusted models, individuals who ceased nicotine use in the last year were less likely to have past-year mood [adjusted odds ratio (AOR) = 0.64; 95% confidence interval (CI) 0.50–0.82, p < 0.001] and substance use disorders (AOR = 0.65, 95% CI 0.52–0.82, p < 0.001) compared to those with current nicotine dependence. They were also less likely to have narcissistic and borderline personality disorders. Compared to those with current nicotine dependence, cessation was associated with an improved quality of life, both physically (beta = 1.65; standard error 0.40, p < 0.001) and mentally (beta = 2.17, standard error 0.39, p < 0.001). In conclusion, nicotine dependence cessation was associated with reduced likelihood of several mental disorders and a higher quality of life compared to those with current nicotine dependence. These findings provide further support for public health policy aimed at smoking cessation.