Cigarette Smoking and Serious Psychological Distress: A Population-Based Study of California Adults

Institute for Health & Aging, School of Nursing, University of California at San Francisco, 3333 California Street, Suite 340, San Francisco, CA 94118, USA.
Nicotine & Tobacco Research (Impact Factor: 3.3). 08/2011; 13(12):1183-92. DOI: 10.1093/ntr/ntr148
Source: PubMed

ABSTRACT This study examines differences in smoking behaviors between adults with and without serious psychological distress (SPD) in California, which has the longest running comprehensive tobacco control program in the world.
Cross-sectional data from the 2007 California Health Interview Survey on 50,880 noninstitutionalized adults were used to analyze smoking prevalence, cigarette consumption, and quit ratio. Persons with SPD were identified using the K6 scale, a clinically validated psychological screening instrument.
About 3.8% of California adults screened positive for SPD in the past 30 days (acute SPD) and an additional 4.8% screened positive for SPD in the past 2-12 months (recent SPD). Persons with SPD were more likely to be current smokers than those without SPD (adjusted odds ratios [AOR] = 2.54, 95% CI = 2.02-3.19 for acute SPD and AOR = 2.20, 95% CI = 1.79-2.71 for recent SPD). Current smokers with acute SPD were more likely to smoke ≥20 cigarettes daily than those without SPD (AOR = 1.59, 95% CI = 1.06-2.39). The quit rate was lower among ever-smokers with acute (AOR = 0.46, 95% CI = 0.35-0.62) or recent SPD (AOR = 0.55, 95% CI = 0.42-0.71) than those without SPD. While persons with acute or recent SPD comprised 8.6% of adults, they consumed 19.2% of all cigarettes in California.
In California, adults with SPD were more likely to be current smokers and to smoke heavily and less likely to quit than those without SPD. The findings underscore the need for effective smoking cessation strategies targeting this group.

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Available from: Michael K Ong, Sep 26, 2015
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    • "Furthermore, the study assessed participants for psychiatric and substance abuse disorders, which are common comorbidities among smokers [15-17], showing the acceptability of the game and the study process among participants with comorbid psychiatric or substance use disorders. "
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    • "The results demonstrate that while a majority of smokers were classified at the time of the survey as “precontemplative” with respect to the readiness to quit, a desire to quit smoking was evident in that the great majority had made quit attempts in the past (82%) and 47% had done so within the last year. Consistent with previous studies, the quit ratio for the current sample was lower than general population rates (Généreux, Roya, Montpetit, Azzoud, & Grattond, 2012; Zhu, Wong, Tang, Shi, & Chen, 2007), and similar to previously reported quit ratios for persons with a mental illness (Lasser et al., 2000; Sung, Prochaska, Ong, Shi, & Max, 2011). Despite a low quit ratio, reflecting a low likelihood of quit attempts translating into successfully maintained smoking cessation, a large proportion of those making a quit attempt in the last 12 months indicated a period of abstinence of more than a month. "
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