schizophrenia, major depression, bipolar disorder, anxiety disorder, panic attacks, attention deficit hyperactivity disorder, posttraumatic stress disorder (PTSD), alcohol abuse, and illicit drug abuse (see Table 3-2 for details) (Lasser et al., 2000; Ziedonis et al., 2008). Results from the NESARC showed that 12-month prevalence of nicotine dependence was 52.4% in those who had any drug disorder, 34.5% in people who had any alcohol-use disorder, 29.2% in those who had any mood disorder, 27.3% in those who had any personality disorder, and 25.3% in those who had any anxiety disorder (Grant et al., 2004). Kotov et al. (2008) found that current smoking rates ranged from 67% to 73% in people who had bipolar, major depressive, or schizophrenia spectrum or other psychotic disorders. Patients who have more severe psychiatric symptoms are more likely to be smokers (Kalman et al., 2005); specifically, those in clinical mental-health treatment centers (outpatient, inpatient, residential, or state mental hospitals) have higher rates of tobacco dependence (American Psychiatric Association, 2006). Smoking is also associated with suicide, although smoking cessation does not appear to be (Hughes, 2008).

TABLE 3-2 Tobacco-Smoking Status and Quit Rates According to Lifetime Presence of Psychiatric Disorder in the United States (%)

Lifetime Diagnosis

US Population

Current Smokers

Lifetime Smokers

Smoking Quit Ratesa

No psychiatric disorder

50.7

22.5

39.1

42.5

Anxiety disorders:

Social phobia

12.5

35.9

54.0

33.4

Posttraumatic stress disorder

6.4

45.3

63.3

28.4

Agoraphobia

5.4

38.4

58.9

34.5

Generalized anxiety disorder

4.8

46.0

68.4

32.7

Panic disorder

3.4

35.9

61.3

41.4

Mood disorders:

Major depression

16.9

36.6

59.0

38.1

Dysthymia

6.8

37.8

60.0

37.0

Bipolar disorder

1.6

68.8

82.5

16.6

Psychotic disorder

(nonaffective)

0.6

49.4

67.9

27.2

a Smoking quit rate defined as proportion of lifetime smokers who were not current smokers (no significant difference in rates when quit rate was defined as not having smoked for more than preceding year).

SOURCE: Adapted with permission from Lasser et al. (2000) and based on National Comorbidity Survey data.



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