Trends in Prevalence of Cigarette Smoking among US Adults with Major Depression or Substance Use Dis
Tuesday, May 24, 2022
Posted by: Natalia Gromov
Han
B, Volkow ND, Blanco C, Tipperman D, Einstein EB, Compton WM.
Trends in Prevalence of
Cigarette Smoking among US Adults with Major Depression or Substance Use
Disorders, 2006-2019.
JAMA.
2022;327(16):1566-1576. doi:10.1001/jama.2022.4790
Importance. Tobacco
use is highly concentrated in persons with mental illness.
Objectives. To
assess trends in past-month prevalence of cigarette smoking among adults with
vs without past-year depression, substance use disorders (SUDs), or both, using
nationally representative data.
Design, setting, and
participants. Exploratory, serial, cross-sectional study
based on data from 558 960 individuals aged 18 years or older who participated
in the 2006-2019 US National Surveys on Drug Use and Health.
Exposure. Past-year
major depressive episode (MDE) and SUD using Diagnostic and Statistical Manual
of Mental Disorders (Fourth Edition, Text Revision) criteria.
Main outcomes and
measures. Past-month self-reported cigarette use, adjusted
for sociodemographic characteristics.
Results. Of
the sampled 558 960 adults, 41.4% (unweighted) were aged 18 to 25 years, 29.8%
(unweighted) were aged 26 to 49 years, and 53.4% (unweighted) were women. From
2006 to 2019, the past-month self-reported cigarette smoking prevalence
declined significantly among adults with MDE from 37.3% to 24.2% for an average
annual percent change of -3.2 (95% CI, -3.5 to -2.8; P < .001), adults with
SUD from 46.5% to 35.8% for an average annual percent change of -1.7 (95% CI,
-2.8 to -0.6; P = .002), and adults with co-occurring MDE and SUD from 50.7% to
37.0% for an annual average annual percent change of -2.1 (95% CI, -3.1 to
-1.2; P < .001). The prevalence declined significantly for each examined
age, sex, and racial and ethnic subgroup with MDE and with SUD (all P <
.05), except for no significant changes in American Indian or Alaska Native
adults with MDE (P = .98) or with SUD (P = .46). Differences in prevalence of
cigarette smoking between adults with vs without MDE declined significantly for
adults overall from 11.5% to 6.6%, for an average annual percent change of -3.4
(95% CI, -4.1 to -2.7; P < .001); significant average annual percent change
declines were also seen for men (-5.1 [95% CI, -7.2 to -2.9]; P < .001); for
women (-2.7 [95% CI, -3.9 to -1.5]; P < .001); for those aged 18 through 25
years (-5.2 [95% CI, -7.6 to -2.8]; P < .001); for those aged 50 years or
older (-4.7 [95% CI, -8.0 to -1.2]; P = .01); for Hispanic individuals (-4.4
[95% CI, -8.0 to -0.5]; P = .03), and for White individuals (-3.6 [95% CI, -4.5
to -2.7]; P < .001). For American Indian or Alaska Native adults, prevalence
did not significantly differ between those with vs without MDE during 2006-2012
but was significantly higher for those with MDE during 2013-2019 (difference,
11.3%; 95% CI, 0.9 to 21.7; P = .04). Differences among those with vs without
SUD declined for women for an average annual percent change of -1.8 (95% CI,
-2.8 to -0.9; P = .001).
Conclusions and
relevance. In this exploratory, serial, cross-sectional
study, there were significant reductions in the prevalence of self-reported
cigarette smoking among US adults with major depressive episode, substance use
disorder, or both, between 2006 and 2019. However, continued efforts are needed
to reduce the prevalence further.
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