Nov. 01 2018

Quit Rates Stalled for Cigarette Smokers With Mental Health Problems

Even as more and more American quit smoking cigarettes, individuals with serious psychological distress (SPD) are much less likely to extinguish their habbit. A new study by scientists at Columbia Mailman School of Public Health and The City University of New York found that individuals with mental health problems quit cigarettes at half the rate of those without psychological distress. The findings are published in the journal Nicotine and Tobacco Research.

“Overall, tobacco cessation programs have been very successful, but our research suggests that people with mental health problems have not benefitted from these,” said Renee Goodwin, PhD, Department of Epidemiology, Columbia Mailman School, and senior author.

Using data from the 2008–2016 National Survey on Drug Use and Health the researchers analyzed cigarette quit rates among people in the U.S. with and without serious psychological distress in the past month. Symptoms of SPD can include feeling nervous, hopeless, worthless, restless or fidgety, so depressed that nothing can cheer one up.

They found that smokers with serious psychological distress in the past month have approximately half the quit rate compared to those without the condition, 24 percent versus 52 percent.  “This trend may be contributing to increasing disparities in smoking rates between those with and without mental health problems,” said Goodwin.

Differences in quit rates may be due to whether and to what degree persons with SPD are seen regularly by healthcare providers. But even if they are, these indviduals may be less likely to be offered smoking cessation treatment than those without mental health problems, according to Goodwin and colleagues. “There has been a long-held belief that mental health problems will be exacerbated by quitting smoking and that smoking is helpful to mental health,” said Goodwin, “but increasingly data support just the opposite.”

An earlier study by Goodwin and colleages found that mental health problems such as depression and anxiety appear to impede successful quitting and sustained abstinence. “It is increasingly clear that tobacco control efforts targeted for those with mental health problems are urgently needed to increase quit rates for this group of smokers and to lower the prevalence of smoking overall,” said Goodwin.

Co-authors are Joanna Streck (first author), University of Vermont; Andrea Weinberger, Albert Einstein College of Medicine; Lauren Pacek, Duke University School of Medicine; and Misato Gbedemah, City University of New York.

The research was supported by National Institute on Drug Abuse (DA20892).