Smoking and mental illness - A population-based prevalence study

Context Studies of selected groups of persons with mental illness, such as those who are institutionalized or seen in mental health clinics, have repo rted rates of smoking to be higher than in persons without mental illness. However, recent population-based, nationally representative data are lackin g. Objective To assess rates of smoking and tobacco cessation in adults, with and without mental illness. Design, Setting, and Participants Analysis of data on 4411 respondents aged 15 to 54 years from the National Comorbidity Survey, a nationally represen tative multistage probability survey conducted from 1991 to 1992. Main Outcome Measures Rates of smoking and tobacco cessation according to t he number and type of psychiatric diagnoses, assessed by a modified version of the Composite International Diagnostic interview, Results Current smoking rates for respondents with no mental illness, lifet ime mental illness, and past-month mental illness were 22.5%, 34.8%, and 41 .0%, respectively. Lifetime smoking rates were 39.1%, 55.3%, and 59.0%, res pectively (P<.001 for all comparisons). Smokers with any history of mental illness had a self-reported quit rate of 37.1% (P=.04), and smokers with pa st-month mental illness had a self-reported quit rate of 30.5% (P<.001) com pared with smokers without mental illness (42.5%). Odds ratios for current and lifetime smoking in respondents with mental illness in the past month v s respondents without mental illness, adjusted for age, sex, and region of the country, were 2.7 (95% confidence interval [CI], 2.3-3.1) and 2.7 (95% CI, 2.4-3.2), respectively. Persons with a mental disorder in the past mont h consumed approximately 44.3% of cigarettes smoked by this nationally repr esentative sample. Conclusions Persons with mental illness are about twice as likely to smoke as other persons but have substantial quit rates.