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BACKGROUND: Tobacco use is one of the most preventable causes of morbidity and mortality. Although there has been a decrease in smoking prevalence over the years, higher prevalence persists among certain subpopulations, including adults with mental illness. Research suggests that people with mental illness are more likely to become addicted to nicotine due to its mood-altering effects; have difficult living conditions such as lower SES that make it difficult to quit; and are targets of direct tobacco marketing. Objective of the study is to examine prevalence and disparities of current cigarette smoking among Kansas adults with Serious Psychological Distress (SPD), Frequent Mental Distress (FMD) in the past 12 months and those who ever were diagnosed with depression.
METHODS: Data from the 2013 Kansas BRFSS were used to calculate estimates of cigarette smoking among Kansas adults aged 18 years and older who had SPD, FMD, and those who ever were diagnosed with depression. Current cigarette smoking among adults who were ever diagnosed with a depression were examined in population subgroups. Logistic regression analyses to examine the relationship between current smoking with depression adjusting for age, gender, race, ethnicity, and education were conducted. Weighted analysis procedures were applied using SAS 9.3 software.
RESULTS: In 2013, about 3.3% of Kansas adults had SPD and 9.7% had FMD. Among those with SPD, 43.2% were current smokers, compared with 18.7% among adults with no SPD (p<.001). Similarly, among those with FMD, 38.2% were current smokers, compared with 18.0% among adults with no FMD (p<.001). Also, about 18.1% of Kansas adults had ever been diagnosed with depression. Among those with depression, 32.1% were current smokers, compared with 17.2% among adults with no depression (p<.001). Smoking prevalence among those with depression was highest among men, adults aged less than 45 years, and those with low annual household income; smoking prevalence among those with depression was lowest among college graduates. Adjusted odds ratio (2.5, 95% confidence intervals, 2.2-2.8) indicated that current smoking is associated with depression.
CONCLUSIONS: Smoking among Kansas adults with mental illness, including SPD, FMD and diagnosed depression, is significantly higher than those without mental illness. Disparities in smoking prevalence among those ever diagnosed with a depressive disorder were also seen with respect to various socio-demographic sub groups. These findings indicate the need for public health strategies to address issues related to smoking among adults with mental illness in Kansas.