Background

Adult smokers with symptoms of any mental illness (AMI) are highly dependent on nicotine and may face additional difficulty quitting smoking. While there is evidence that adult smokers with AMI have high dependence, there is insufficient evidence regarding the unique role that AMI may play in moderating the relationship between dependence and cessation outcomes over time.

Methods

7290 current established adult smokers at Wave 1 (2013–2014) of the PATH Study also participated in data collection in Waves 2–4 (2014–2018). Linear probability models with individual-level random effects were fit to the data, modeling associations between AMI, nicotine dependence, and the 1) likelihood of achieving cessation during the study period, 2) making a cessation attempt within the previous 12 months, and 3) log of past 30-day total consumption of cigarettes.

Results

Adults who experienced both AMI symptoms and high dependence were 4.7 percentage points (PP) less likely to achieve cessation at any point during the study period (p < 0.01) and smoked more cigarettes per month (β = 0.214, p < 0.05) than adults with AMI who were not highly dependent, despite being as likely to attempt to quit. Adults with AMI who were not highly dependent were 4.6 PP more likely to report a quit attempt and 1.6 PP more likely to achieve cessation than those with neither AMI nor high dependence.

Conclusions

Adults with AMI are particularly affected by the burden of tobacco use, in part because of the likely interaction between nicotine dependence and AMI. Tobacco control efforts that focus on this interplay may provide an opportunity to better target interventions for this vulnerable population.

中文翻译：

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尼古丁依赖、心理健康和戒烟尝试的纵向评估：来自烟草与健康人口评估 (PATH) 研究第 1-4 波的证据

背景

有任何精神疾病 (AMI) 症状的成年吸烟者高度依赖尼古丁，并且可能面临更多的戒烟困难。虽然有证据表明患有 AMI 的成年吸烟者具有高度依赖，但没有足够的证据表明 AMI 在缓和依赖和戒烟结果之间的关系方面可能发挥的独特作用。

方法

PATH 研究第 1 波（2013-2014 年）的 7290 名现有成年吸烟者也参与了第 2-4 波（2014-2018 年）的数据收集。具有个体水平随机效应的线性概率模型适合数据，模拟 AMI、尼古丁依赖和 1) 在研究期间实现戒烟的可能性、2) 在过去 12 个月内尝试戒烟和 3 之间的关联) 过去 30 天卷烟总消费量的日志。

结果

在研究期间的任何时候，同时出现 AMI 症状和高度依赖的成年人实现戒烟的可能性降低 4.7 个百分点 (p < 0.01)，并且每月吸烟量比成年人多 (β = 0.214，p < 0.05)尽管有可能试图戒烟，但并不高度依赖的 AMI。与既没有 AMI 也没有高度依赖的人相比，非高度依赖的 AMI 成人报告戒烟尝试的可能性高 4.6 PP，实现戒烟的可能性高 1.6 PP。

结论

患有 AMI 的成年人尤其受到烟草使用负担的影响，部分原因是尼古丁依赖与 AMI 之间可能存在相互作用。关注这种相互作用的烟草控制工作可能会提供一个机会，以更好地针对这一弱势群体采取干预措施。