Disparities in smoking behaviors among persons with and without serious psychological distress in California

The objective of this study was to contrast smoking behaviors of persons with and without serious psychological distress (SPD) in California. Using data from the 2007 California Health Interview Survey, we assessed smoking prevalence (lifetime and current), smoking intensity, and quit behaviors by SPD status. Among 50,880 adults, 8.5% screened positive for SPD in the past 12 months, and 3.8% screened positive for SPD in the past 30 days. Current smoking prevalence for persons without SPD in the past year, those with 12-month SPD, and those with 30-day SPD was 13.1%, 28.5%, and 30.1%, respectively. Lifetime smoking prevalence was 37.0%, 48.5%, and 52.4%, respectively. Lifetime smokers' quit rates for persons with 12-month SPD (41.2%) or 30-day SPD (42.5%) was significantly lower than those for persons without past year SPD (64.5%). Among persons without past year SPD, those with 12-month SPD, and those with 30-day SPD, the proportion of current smokers who smoked daily was 66.4%, 71.9%, and 75.4%; daily smokers' mean(SE) number of cigarettes per day was 12.7(0.3), 13.8(0.5), and 15.2(0.6), respectively. After adjusting for confounding factors, we found that those with SPD were about twice as likely to be current smokers as those without SPD, more likely to smoke more heavily, and less likely to quit smoking. Although those with 12-month SPD accounted for 8.5% of adults, they consumed almost 20% of total cigarettes smoked by this California sample. Our findings highlight the importance of enhancing smoking cessation efforts tailored to persons with mental illness.