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The percentage of adults with major depression and/or substance use disorder who reported smoking cigarettes declined between 2006 and 2019, according to a report published today in JAMA.
“This study shows us that, at a population-level, reductions in tobacco use are achievable for people with psychiatric conditions, and smoking cessation should be prioritized along with treatments for substance use, depression, and other mental health disorders for people who experience them,” Nora Volkow, M.D., director of the National Institute on Drug Abuse (NIDA) and co-author of the study, said in a news release. “Therapies to help people stop smoking are safe, effective, and may even enhance the long-term success of concurrent treatments for more severe mental health symptoms in individuals with psychiatric disorders by lowering stress, anxiety, depression, and by improving overall mood and quality of life.”
Volkow together with lead author Beth Han, M.D., Ph.D., of NIDA and colleagues analyzed data from adults 18 years and older who participated in the annual National Survey on Drug Use and Health (NSDUH) between 2006 and 2019. As part of the NSDUH, interviewers asked participants about lifetime, past-year, and past-month use of tobacco and alcohol, misuse of prescription opioids, and more. The participants were also asked about any past-year major depressive episode (using DSM-IV criteria) and sociodemographic characteristics (such as age, sex, race and ethnicity, employment status, family income, and more). Han and colleagues specifically focused on data on past-month cigarette use from 558,960 adult participants.
Past-month prevalence of cigarette smoking and any tobacco use were consistently higher among those with a major depressive episode, alcohol use disorder, drug use disorder, substance use disorder, or co-occurring major depressive episode and substance use disorder than among those without the corresponding conditions, Han and colleagues reported. After controlling for sociodemographic characteristics, the researchers found that overall past-month cigarette smoking significantly declined from 2006 to 2019 among those with a major depressive episode (37.3% to 24.2%), substance use disorder (46.5% to 35.8%), or both (50.7% to 37.0%).
Differences in the prevalence of cigarette smoking between adults with a major depressive episode versus those without a major depressive episode also declined for all groups analyzed except for American Indians or and Alaska Natives. “For American Indian or Alaska Native adults, prevalence did not significantly differ between those with vs without [a major depressive episode] during 2006-2012 but was significantly higher for those with [a major depressive episode] during 2013-2019,” Han and colleagues wrote.
Han and colleagues noted several limitations of the study, including that the only non-substance use disorder mental illness measured directly by the NSDUH was major depressive episode and that the data predate the COVID-19 pandemic.
For related information, see the American Journal of Psychiatry article “Efficacy of Combining Varenicline and Naltrexone for Smoking Cessation and Drinking Reduction: A Randomized Clinical Trial.”
(Image: iStock/Sezeryadigar)
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