Dataset Information

Diverging trends in smoking behaviors according to mental health status.

ABSTRACT:

Introduction

People with mental health disorders are much more likely to smoke compared to those who do not. This study investigates recent trends in smoking behaviors among both these populations in England.

Methods

We used survey responses from adults (aged 16 years and older) living in households in England who participated in the Health Survey for England from 1993 to 2011 (n = 11,300 per year on average). Linear regression was used to quantify annual changes over the time period in smoking prevalence, daily cigarette consumption, and desire to quit among respondents with and without 2 indicators of mental disorder (self-reported longstanding mental illness and recent use of psychoactive medication).

Results

Among survey respondents who did not report a longstanding mental illness, there were long-term declines in smoking prevalence (-0.48% per year, 95% confidence interval [CI] = -0.56 to -0.40) and daily cigarette consumption (-0.14% per year, 95% CI = -0.17 to -0.11). Similar declines were also seen among respondents not taking psychoactive medications. However, there were no long-term changes in smoking prevalence and cigarette consumption among respondents who reported these indicators of mental disorder, although smoking prevalence among those taking psychoactive medications may have declined during the later part of the study period. Smokers both with and without the 2 indicators of mental disorder showed similar levels of desire to quit smoking.

Conclusions

Smoking is largely unchanged since 1993 among those with indicators of longstanding mental disorders or recent psychoactive medication usage, although declines have been observed among those without such indicators of mental disorder.

SUBMITTER: Szatkowski L

PROVIDER: S-EPMC5479511 | biostudies-literature | 2015 Mar

REPOSITORIES: biostudies-literature

ACCESS DATA

Similar Datasets

Project description:Significant progress has been made in reducing the prevalence of tobacco use in the United States. However, tobacco cessation efforts have focused on the general population rather than individuals with mental illness, who demonstrate greater rates of tobacco use and nicotine dependence.To assess whether declines in tobacco use have been realized among individuals with mental illness and examine the association between mental health treatment and smoking cessation.Use of nationally representative surveys of noninstitutionalized US residents to compare trends in smoking rates between adults with and without mental illness and across multiple disorders (2004-2011 Medical Expenditure Panel Survey [MEPS]) and to compare rates of smoking cessation among adults with mental illness who did and did not receive mental health treatment (2009-2011 National Survey of Drug Use and Health [NSDUH]).The MEPS sample included 32,156 respondents with mental illness (operationalized as reporting severe psychological distress, probable depression, or receiving treatment for mental illness) and 133,113 without mental illness. The NSDUH sample included 14,057 lifetime smokers with mental illness.Current smoking status (primary analysis; MEPS sample) and smoking cessation, operationalized as a lifetime smoker who did not smoke in the last 30 days (secondary analysis; NSDUH sample).Adjusted smoking rates declined significantly among individuals without mental illness (19.2% [95% CI, 18.7-19.7%] to 16.5% [95% CI, 16.0%-17.0%]; P?<?.001) but changed only slightly among those with mental illness (25.3% [95% CI, 24.2%-26.3%] to 24.9% [95% CI, 23.8%- 26.0%]; P?=?.50), a significant difference in difference of 2.3% (95% CI, 0.7%-3.9%) (P?=?.005). Individuals with mental illness who received mental health treatment within the previous year were more likely to have quit smoking (37.2% [95% CI, 35.1%-39.4%]) than those not receiving treatment (33.1% [95% CI, 31.5%-34.7%]) (P?=?.005).Between 2004 and 2011, the decline in smoking among individuals with mental illness was significantly less than among those without mental illness, although quit rates were greater among those receiving mental health treatment. This suggests that tobacco control policies and cessation interventions targeting the general population have not worked as effectively for persons with mental illness.

Project description:BACKGROUND: No study has been carried out on the time trend in the prevalence of chronic bronchitis (CB) in recent years, despite its clinical and epidemiological relevance. We evaluated the trend in CB prevalence during the past decade among young Italian adults. METHODS: A screening questionnaire was mailed to general population samples of 20-44 year-old subjects in two cross-sectional surveys: the Italian Study on Asthma in Young Adults (ISAYA) (1998/2000; n = 18,873, 9 centres) and the screening stage of the Gene Environment Interactions in Respiratory Diseases (GEIRD) study (2007/2010; n = 10,494, 7 centres). CB was defined as having cough and phlegm on most days for a minimum of 3 months a year and for at least 2 successive years. The prevalence rates and the risk ratios (RRs) for the association between CB and each potential predictor were adjusted for gender, age, season of response, type of contact, cumulative response rate, and centre. RESULTS: CB prevalence was 12.5% (95% CI: 12.1-12.9%) in 1998/2000 and 12.6% (95% CI: 11.7-13.7%) in 2007/2010; it increased among never smokers (from 7.6 to 9.1%, p = 0.003), current light smokers (<15 pack-years; from 15.1 to 18.6%, p < 0.001), and unemployed/retired subjects (from 14.3 to 19.1%, p = 0.001). In this decade, the prevalence of current smoking decreased (from 33.6 to 26.9%, p < 0.001), whereas the prevalence of unemployment/premature retirement (from 5.3 to 6.0%, p = 0.005), asthma (from 5.0 to 6.2%, p = 0.003), and allergic rhinitis (from 19.5 to 24.5%, p < 0.001) increased. In both 1998/2000 and 2007/2010, the likelihood of having CB was significantly higher for women, current smokers, asthmatic patients, and subjects with allergic rhinitis. During this period, the strength of the association between CB and current heavy smoking (?15 pack-years) decreased (RR: from 4.82 to 3.57, p = 0.018), whereas it increased for unemployment/premature retirement (from 1.11 to 1.53, p = 0.019); no change was observed for gender, asthma, and allergic rhinitis. CONCLUSIONS: Despite the significant reduction in current smoking, CB prevalence did not vary among young Italian adults. The temporal pattern of CB prevalence can only be partly explained by the increase of unemployment/premature retirement, asthma and allergic rhinitis, and suggests that other factors could have played a role.

Project description:OBJECTIVE:To advance the goal of "Grand Convergence" in global health by 2035, this study tested the convergence hypothesis in the progress of the health status of individuals from 193 countries, using both standard and cutting-edge convergence metrics. METHODS:The study used multiple data sources. The methods section is categorized into two parts. (1) Health inequality measures were used for estimating inter-country inequalities. Dispersion Measure of Mortality (DMM) is used for measuring absolute inequality and Gini Coefficient for relative inequality. (2) We tested the standard convergence hypothesis for the progress in Infant Mortality Rate (IMR) and Life Expectancy at Birth (LEB) during 1950 to 2015 using methods ranging from simple graphical tools (catching-up plots) to standard parametric (absolute β and σ-convergence) and nonparametric econometric models (kernel density estimates) to detect the presence of convergence (or divergence) and convergence clubs. FINDINGS:The findings lend support to the "rise and fall" of world health inequalities measured using Life Expectancy at Birth (LEB) and Infant Mortality Rate (IMR). The test of absolute β-convergence for the entire period and in the recent period supports the convergence hypothesis for LEB (β = -0.0210 [95% CI -0.0227 - -0.0194], p<0.000) and rejects it for IMR (β = 0.0063 [95% CI 0.0037-0.0089], p<0.000). However, results also suggest a setback in the speed of convergence in health status across the countries in recent times, 5.4% during 1950-55 to 1980-85 compared to 3% during 1985-90 to 2010-15. Although inequality based convergence metrics showed evidence of divergence replacing convergence during 1985-90 to 2000-05, from the late 2000s, divergence was replaced by re-convergence although with a slower speed of convergence. While the non-parametric test of convergence shows an emerging process of regional convergence rather than global convergence. CONCLUSION:We found that with a current rate of progress (2.2% per annum) the "Grand convergence" in global health can be achieved only by 2060 instead of 2035. We suggest that a roadmap to achieve "Grand Convergence" in global health should include more radical changes and work for increasing efficiency with equity to achieve a "Grand convergence" in health status across the countries by 2035.