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Lasser K, Boyd JW, Woolhandler S, Himmelstein DU, McCormick D, Bor DH. Smoking and Mental Illness: A Population-Based Prevalence Study. JAMA. 2000;284(20):2606–2610. doi:10.1001/jama.284.20.2606
Author Affiliations: Departments of Medicine (Drs Lasser, Woolhandler, Himmelstein, McCormick, and Bor) and Psychiatry (Dr Boyd), The Cambridge Hospital and Harvard Medical School, Cambridge, Mass; and Department of Religion, Smith College, Northampton, Mass (Dr Boyd).
Context Studies of selected groups of persons with mental illness, such as those
who are institutionalized or seen in mental health clinics, have reported
rates of smoking to be higher than in persons without mental illness. However,
recent population-based, nationally representative data are lacking.
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 representative multistage probability survey
conducted from 1991 to 1992.
Main Outcome Measures Rates of smoking and tobacco cessation according to the 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, lifetime
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%, respectively
(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 past-month mental illness had a self-reported
quit rate of 30.5% (P<.001) compared with smokers
without mental illness (42.5%). Odds ratios for current and lifetime smoking
in respondents with mental illness in the past month vs 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 month consumed approximately 44.3%
of cigarettes smoked by this nationally representative sample.
Conclusions Persons with mental illness are about twice as likely to smoke as other
persons but have substantial quit rates.
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