Cited by 519Smoking Behavior and CessationSubstance Abuse Treatment and OutcomesMental Health Treatment and Access

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Trends in Smoking Among Adults With Mental Illness and Association Between Mental Health Treatment and Smoking Cessation

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Cook, Benjamin Lê, Wayne, Geoff Ferris, Kafali, E. Nilay, Liu, Zimin, Shu, Chang, Flores, Michael·2014·JAMA

DOI 10.1001/jama.2013.284985PMC PMC5555156

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Abstract

IMPORTANCE: 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. OBJECTIVES: 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. DESIGN, SETTING, AND PARTICIPANTS: 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. MAIN OUTCOMES AND MEASURES: 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). RESULTS: 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). CONCLUSIONS AND RELEVANCE: 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.

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Method
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Weinberger, A. H., Streck, J. M., Pacek, L. R., & Goodwin, R. D. (2018) · The Journal of Clinical Psychiatry · doi:10.4088/jcp.17m11945 · Cited by 20
Glucagon-like peptide-1 receptor agonists (GLP-1RAs) as treatment for nicotine cessation in psychiatric populations: a systematic review
Lee, S. M. L., Li, M., Le, G. H., Teopiz, K. M., Vinberg, M., Ho, R., Au, H. C. T., Wong, S., Valentino, K., Kwan, A. T. H., et al. (2024) · Annals of General Psychiatry · doi:10.1186/s12991-024-00527-9 · Cited by 25
“The health impact of nicotine consumption is asymmetric in the general population insofar as higher rates of smoking are reported in minority groups, economically disadvantaged as well as persons living with mental disorders [29].”
The association between social support and smoking status in cancer survivors with frequent and infrequent mental distress: results from 10 US states, 2010
Poghosyan, H., Darwish, S. A., Kim, S. S., & Cooley, M. E. (2016) · Journal of Cancer Survivorship · doi:10.1007/s11764-016-0551-6 · Cited by 20
Improved Depressive Symptoms in Adults with Schizophrenia During a Smoking Cessation Attempt with Varenicline and Behavioral Therapy
Cather, C., Hoeppner, S. S., Pachas, G. N., Pratt, S., Achtyes, E. D., Cieslak, K. M., & Evins, A. E. (2017) · Journal of Dual Diagnosis · doi:10.1080/15504263.2017.1319585 · Cited by 20
“contribute to their low smoking cessation rates (Cook et al., 2014) and excess morbidity and mortality (Callaghan et al.”
Background
Socioeconomic Disparities in Smoking Among U.S. Adults With Depression, 2005–2014
Weinberger, A. H., Bandiera, F. C., Leventhal, A. M., Dierker, L., Gbedemah, M., Tidey, J. W., & Goodwin, R. D. (2018) · American Journal of Preventive Medicine · doi:10.1016/j.amepre.2018.02.008 · Cited by 20
Discussions of Alcohol Use in an Online Social Network for Smoking Cessation: Analysis of Topics, Sentiment, and Social Network Centrality
Cohn, A. M., Amato, M. S., Zhao, K., Wang, X., Cha, S., Pearson, J., Papandonatos, G. D., & Graham, A. L. (2018) · Alcoholism Clinical and Experimental Research · doi:10.1111/acer.13906 · Cited by 20
Quitting behaviours and cessation methods used in eight European Countries in 2018: findings from the EUREST-PLUS ITC Europe Surveys
Papadakis, S., Katsaounou, P. A., Kyriakos, C. N., Balmford, J., Tzavara, C., Girvalaki, C., Driezen, P., Filippidis, F. T., Herbeć, A., Hummel, K., et al. (2020) · European Journal of Public Health · doi:10.1093/eurpub/ckaa082 · Cited by 20
“Consistent with our data, the presence of depression has been linked to higher nicotine dependence, lower rates of quitting, greater difficulty with quitting and higher rates of relapse(20,21).”
Background
Maintenance pharmacotherapy normalizes the relapse curve in recently abstinent tobacco smokers with schizophrenia and bipolar disorder
Evins, A. E., Hoeppner, S. S., Schoenfeld, D., Hoeppner, B. B., Cather, C., Pachas, G. N., Cieslak, K. M., & Maravić, M. C. (2016) · Schizophrenia Research · doi:10.1016/j.schres.2016.11.018 · Cited by 20
“2012) smoking rates are not declining among those with psychiatric illness (Cook et al. 2014).”
Influential
A systematic review of digital interventions for smoking cessation in patients with serious mental illness
Martinez Agulleiro, L., Patil, B., Firth, J., Sawyer, C., Amann, B. L., Fonseca, F., Torrens, M., Perez, V., Castellanos, F. X., Kane, J. M., et al. (2023) · Psychological Medicine · doi:10.1017/s003329172300123x · Cited by 19
Co-occurring tobacco use and posttraumatic stress disorder: Smoking cessation treatment implications: Tobacco Use in Posttraumatic Stress Disorder
Kelly, M. M., Jensen, K. P., & Sofuoglu, M. (2015) · The American Journal on Addictions · doi:10.1111/ajad.12304 · Cited by 23
The Effect of Safety Net Generosity on Maternal Mental Health and Risky Health Behaviors
Schmidt, L., Shore-Sheppard, L. D., & Watson, T. E. (2023) · Journal of Policy Analysis and Management · doi:10.1002/pam.22481 · Cited by 19
Predictors of Tobacco Use Among New York State Addiction Treatment Patients
Guydish, J. R., Jiang, Y., Le, T. L., Pagano, A., & Delucchi, K. (2014) · American Journal of Public Health · doi:10.2105/ajph.2014.302096 · Cited by 18
“Behavioral health populations, especially, have not benefited from the overall population decline in smoking prevalence.(10) People with mental health diagnoses are twice as likely to smoke as those without,(11) and the highest prevalence rates reported are among people who seek treatment for alcohol or drug addiction.”
Background
Uptake of smoking cessation aids by smokers with a mental illness
Metse, A. P., Wiggers, J. H., Wye, P. M., Clancy, R., Moore, L., Adams, M., Robinson, M., & Bowman, J. (2016) · Journal of Behavioral Medicine · doi:10.1007/s10865-016-9757-3 · Cited by 19
“Over the past two decades, the proportion of smokers in Australia (Australian Institute of Health and Welfare, 2011) and other high income countries (Cook et al., 2014; Office for National Statistics, 2014) has approximately halved.”
Background
Major Depressive Disorder and Lifestyle: Correlated Genetic Effects in Extended Twin Pedigrees
Huider, F., Milaneschi, Y., van der Zee, M. D., de Geus, E. J. C., Helmer, Q., Penninx, B. W. J. H., & Boomsma, D. I. (2021) · Genes · doi:10.3390/genes12101509 · Cited by 19
“Epidemiological data show smoking rate to be increased in clinically depressed individuals at twice the rate of the general population [19,20], and both population-based studies as well as prospective cohort studies find elevated risk of MDD in those who smoke [21–23].”
Result
Lessons from Practice
Bhattacharya, A., Vilardaga, R., Kientz, J. A., & Munson, S. A. (2017) · CHI Conference on Human Factors in Computing Systems · doi:10.1145/3025453.3025725 · Cited by 21
“Individuals report different triggers for smoking and relapsing, experience different levels of difficulty with nicotine withdrawal, or may use smoking as a coping strategy for comorbid mental health conditions such as anxiety and depression [16,49].”
Background
The effectiveness and safety of combining varenicline with nicotine e-cigarettes for smoking cessation in people with mental illnesses and addictions: study protocol for a randomised-controlled trial
Bullen, C., Verbiest, M. E. A., Galea, S., Kurdziel, T., Laking, G. R., Newcombe, D. A. L., Parag, V., & Walker, N. K. (2018) · BMC Public Health · doi:10.1186/s12889-018-5351-7 · Cited by 18
“Although smokers with mental illnesses and/or AOD addictions are just as motivated as others to quit smoking [6] they are less likely to succeed [4, 7, 8].”
Background
Concurrent Mental Illness and Financial Barriers to Mental Health Care Among a Nationally Representative Sample of Orthopaedic Trauma Survivors
Jella, T. K., Cwalina, T. B., & Vallier, H. A. (2022) · Journal of Orthopaedic Trauma · doi:10.1097/bot.0000000000002433 · Cited by 17
Cigarette smoking, nicotine dependence, and motivation to quit smoking in South African male psychiatric inpatients
Plooy, J.-L. D., Macharia, M., & Verster, C. (2016) · BMC Psychiatry · doi:10.1186/s12888-016-1123-z · Cited by 17
“Although global and South African prevalence of smoking has decreased in the general population as a result of anti-smoking regulations and extensive public campaigns [18–20], rates have declined much less, if at all, in people with mental disorders [21].”
Background
Associations Between Comorbid Health Conditions and Quit Outcomes Among Smokers Enrolled in a State Quitline, Arizona, 2011-2016
Nair, U. S., Bell, M. L., Yuan, N. P., Wertheim, B. C., & Thomson, C. A. (2018) · Public Health Reports · doi:10.1177/0033354918764903 · Cited by 18
“among the general population,(4) smokers with such comorbid health conditions continue to have challenges to successful cessation.(8,9) Tobacco cessation quitlines are a pragmatic and costefficient strategy to deliver evidence-based cessation interventions.”
Background
Managing physical and mental health conditions: Consumer perspectives on integrated care
Rollins, A. L., Wright-Berryman, J., Henry, N. H., Quash, A. M., Benbow, K. L., Bonfils, K., Hedrick, H. M., Miller, A. P., Firmin, R., & Salyers, M. P. (2016) · Social Work in Mental Health · doi:10.1080/15332985.2016.1173160 · Cited by 17
“…sustained approaches targeted toward consumers with SMI, above and beyond interventions targeting the general population, to address smoking cessation (Cook et al., 2014; Evins et al., 2014; Schroeder & Morris, 2010) and weight reduction (Bartels & Desilets, 2012; Daumit et al., 2013).”
Background
Cancer and severe mental illness in low‐ and middle‐income countries: The challenges and outlook for the future
Park, S. J., Wai, A., Pavithran, K., Kunheri, B., & Valsraj, K. M. (2021) · Psycho-Oncology · doi:10.1002/pon.5796 · Cited by 16
“poorer understanding of the effects to health, influence from peers, and habits picked up from time spent in psychiatric institutions.(25)”
Background
High prevalence of falsely declaring nicotine abstinence in lung transplant candidates
Veit, T., Munker, D., Leuschner, G., Mümmler, C., Sisic, A., Kauke, T., Schneider, C. P., Irlbeck, M., Michel, S. G., Eser-Valerie, D., et al. (2020) · PLoS ONE · doi:10.1371/journal.pone.0234808 · Cited by 16
“[21] Lung transplant candidates with a psychiatric and addictive history might benefit from targeted cessation intervention.”
Background
Marijuana Use and Adherence to Smoking Cessation Treatment Among Callers to Tobacco Quitlines
Carpenter, K., Torres, A. J., Salmon, E. E., Carlini, B. H., Vickerman, K. A., Schauer, G. L., & Bush, T. M. (2020) · Preventing Chronic Disease · doi:10.5888/pcd17.200110 · Cited by 16
Chronic obstructive pulmonary disease in severe mental illness: A timely diagnosis to advance the process of quitting smoking
Jaén‐Moreno, M. J., Feu, N., del Pozo, G. I., Gómez, C., Carrión, L., Chauca, G. M. C., Guler, I., Montiel, F. J., Sánchez, M. D., Alcalá, J. A., et al. (2021) · European Psychiatry · doi:10.1192/j.eurpsy.2021.12 · Cited by 17
Nicotine Withdrawal, Relapse of Mental Illness, or Medication Side-Effect? Implementing a Monitoring Tool for People With Mental Illness Into Quitline Counseling
Segan, C., Baker, A., Turner, A., & Williams, J. M. (2017) · Journal of Dual Diagnosis · doi:10.1080/15504263.2016.1276657 · Cited by 16
“…Smoking cessation; mental illness; nicotine withdrawal; medication side effects; quitline; telephone counseling Tobacco smoking rates are much higher in people living with mental illness compared to the general population, and are not showing the same rates of decline over time (Cook et al., 2014).”
Background
Association of perceived stress with health status outcomes in patients with peripheral artery disease
Malik, A. O., Peri-Okonny, P., GOSCH, K. L., Thomas, M. B., Mena‐Hurtado, C., Hiatt, W. R., Aronow, H. D., Jones, P. G., Provance, J., Labrosciano, C., et al. (2020) · Journal of Psychosomatic Research · doi:10.1016/j.jpsychores.2020.110313 · Cited by 19
“These include development of adverse health behaviors such as physical inactivity[34], obesity[27] and smoking[35].”
Background
Service‐user experiences of an integrated psychological intervention for depression or anxiety and tobacco smoking in improving access to psychological therapies services: A qualitative investigation into mechanisms of change in quitting smoking.
Fredman Stein, K., Sawyer, K., Daryan, S., Allen, J., & Taylor, G. (2023) · Health Expectations · doi:10.1111/hex.13684 · Cited by 11
Prevalence of smoking, quit attempts and access to cessation treatment among adults with mental illness in Brazil: a cross-sectional analysis of a National Health Survey
Cruvinel, É., Liebmann, E. P., Leite, I. C. G., Hu, J., & Richter, K. P. (2020) · BMJ Open · doi:10.1136/bmjopen-2019-033959 · Cited by 15
Prevalence and Factors Associated with Tobacco Smoking in a National Representative Sample of Zambian Adults: Data from the 2017 STEPS – NCDs Survey
Zyambo, C. M., Olowski, P., Mulenga, D., Syapiila, P., Liwewe, M. M., Ngoma-Hazemba, A., Halwiindi, H., & Siziya, S. (2023) · Asian Pacific Journal of Cancer Prevention · doi:10.31557/apjcp.2023.24.1.111 · Cited by 16
“We have further characterized the association of mental health problems and tobacco smoking (Cook et al., 2014; Zyambo et al., 2019), demonstrating that people who seriously considered suicide were twice more likely to smoke tobacco.”
Background
Investigating the Relationship between Oral Health and Severe Mental Illness: Analysis of NHANES 1999–2016
Kang, J. X., Wu, J., Aggarwal, V. R., Shiers, D., Doran, T., & Palmier‐Claus, J. E. (2024) · Dentistry Journal · doi:10.3390/dj12070191 · Cited by 18
“There is strong evidence to suggest that people with SMI are more likely to smoke and smoke more heavily than the general population [12,33], and the findings provide evidence of its harmful effect on oral health, consistent with other studies [34,35].”
Smokers with serious mental illness and requests for nicotine replacement therapy post-hospitalisation
Schuck, R. K., Dahl, A., Hall, S. M., Delucchi, K., Fromont, S. C., Hall, S. E., Bonas, T., & Prochaska, J. J. (2014) · Tobacco Control · doi:10.1136/tobaccocontrol-2014-051712 · Cited by 18
Profile of tobacco users identified in primary care practice and predictors of readiness to quit: a cross-sectional survey
Papadakis, S., Tulloch, H. E., Gharib, M., & Pipe, A. (2016) · CMAJ Open · doi:10.9778/cmajo.20150055 · Cited by 15
Patient perspectives on how living with a mental illness affects making and maintaining healthy lifestyle changes
Yarborough, B. J. H., Stumbo, S. P., Cavese, J. A., Yarborough, M. T., & Green, C. A. (2018) · Patient Education and Counseling · doi:10.1016/j.pec.2018.08.036 · Cited by 14
Psychiatric comorbidities in a comparative effectiveness smoking cessation trial: Relations with cessation success, treatment response, and relapse risk factors
Johnson, A. L., Kaye, J. T., Baker, T. B., Fiore, M. C., Cook, J. W., & Piper, M. E. (2019) · Drug and Alcohol Dependence · doi:10.1016/j.drugalcdep.2019.107796 · Cited by 17
Integrated care models and behavioral health care utilization: Quasi‐experimental evidence from Medicaid health homes
McClellan, C. B., Maclean, J. C., Saloner, B. K., McGinty, E. E., & Pesko, M. F. (2020) · Health Economics · doi:10.1002/hec.4027 · Cited by 15
“…and poor health behaviors (e.g., smoking, diabetes, cardiovascular disease) and less likely to receive guideline-concordant care for behavioral and general health conditions than other insured populations (Busch et al., 2013, Creedon and Cook, 2016, Janssen et al., 2015, Cook et al., 2014).”
Background
Type 2 Diabetes in Children and Adolescents on Atypical Antipsychotics
Pramyothin, P., & Khaodhiar, L. (2015) · Current Diabetes Reports · doi:10.1007/s11892-015-0623-4 · Cited by 16
Predictors of tobacco abstinence in outpatient smokers with schizophrenia or bipolar disorder treated with varenicline and cognitive behavioral smoking cessation therapy
Schuster, R. M., Cather, C., Pachas, G. N., Zhang, H., Cieslak, K. M., Hoeppner, S. S., Schoenfeld, D., & Evins, A. E. (2017) · Addictive Behaviors · doi:10.1016/j.addbeh.2017.02.028 · Cited by 15
“…disorder (Dickerson et al., 2013; Hartz et al., 2014; Kreinin et al., 2012), compared to 18% of the general U.S. population (Agaku et al., 2014; Le Cook et al., 2014; Address correspondence to Corinne Cather, PhD, MGH Center for Addiction Medicine, 60 Staniford Street Boston, MA 02114,…”
Background
Impact of Tobacco Quitlines on Smoking Cessation in Persons With Mental Illness: A Systematic Review
Schwindt, R. G., Hudmon, K. S., Knisely, M. R., Davis, L. L., & Pike, C. A. (2017) · Journal of Drug Education · doi:10.1177/0047237918762104 · Cited by 15
Psychological distress and responses to comparative risk messages about electronic and combusted cigarettes
Yang, B. K., Spears, C. A., & Popova, L. (2018) · Addictive Behaviors · doi:10.1016/j.addbeh.2018.11.025 · Cited by 15
Relapse to smoking and health-related quality of life: Secondary analysis of data from a study of smoking relapse prevention
Song, F., Bachmann, M. O., Aveyard, P. N., Barton, G., Brown, T. J., Maskrey, V., Blyth, A., Notley, C. J., Holland, R., Sutton, S. R., et al. (2018) · PLoS ONE · doi:10.1371/journal.pone.0205992 · Cited by 15
A pilot study of Counsel to Quit®: Evaluating an Ask Advise Refer (AAR)-based tobacco cessation training for medical and mental healthcare providers
Chavarria, J., Liu, M. A., Kast, L., Salem, E., & King, A. C. (2019) · Journal of Substance Abuse Treatment · doi:10.1016/j.jsat.2019.01.024 · Cited by 15
Use of and Perceptions about Electronic Nicotine Delivery Systems (ENDS) among People with Mental Health Conditions or Serious Psychological Distress, 2018
Spears, C., Jones, D. M., Weaver, S. R., Yang, B., Pechacek, T., & Eriksen, M. (2020) · Drug and Alcohol Dependence · doi:10.1016/j.drugalcdep.2020.108049 · Cited by 15
“population has been a public health success, tobacco control strategies have worked less well for people with MHC (Cook et al., 2014; Lawrence and Williams, 2016).”
Background
Strategies to deal with comorbid physical illness in psychosis
Docherty, M. J., Stubbs, B., & Gaughran, F. (2016) · Epidemiology and Psychiatric Sciences · doi:10.1017/s2045796016000056 · Cited by 16
“Whilst public health initiatives such as smoking cessation campaigns have been successful in driving down smoking rates in the general population, relatively little progress has been made among people with SMI with the smoking gap continuing to widen (Cook et al. 2014).”
Background
Effect of a Tobacco Cessation Intervention Incorporating Weight Management for Adults With Serious Mental Illness: A Randomized Clinical Trial
Daumit, G. L., Evins, A. E., Cather, C., Dalcin, A. T., Dickerson, F. B., Miller, E. R., Appel, L. J., Jerome, G. J., McCann, U., Ford, D. E., et al. (2023) · JAMA Psychiatry · doi:10.1001/jamapsychiatry.2023.1691 · Cited by 13
Routine screening of hospital patients for secondhand tobacco smoke exposure: A feasibility study
Kruse, G. R., & Rigotti, N. A. (2014) · Preventive Medicine · doi:10.1016/j.ypmed.2014.09.017 · Cited by 14
“The high rate of smoking among individuals with psychiatric diagnoses (Cook et al., 2014) may explain why nonsmokers with these diagnoses have a high rate of exposure to SHS.”
Background
Does new health information affect health behaviour? The effect of health events on smoking cessation
Bünnings, C. (2016) · Applied Economics · doi:10.1080/00036846.2016.1210766 · Cited by 14
“Hence, individuals who suffer from mental problems seem to have a considerably smaller probability to quit, which is consistent with findings by Lasser et al. (2000) and Leê Cook et al. (2014).”
Result
Smoking Ban in Psychiatric Inpatient Unit: An Iranian Study on the Views and Attitudes of the Mental Health Staff and Psychiatric Patients
Beyraghi, N., Meybodi, A. M., & Bahri, R. J. (2018) · Psychiatry Journal · doi:10.1155/2018/2450939 · Cited by 14

Authors: Cook, B. L., Wayne, G. F., Kafali, E. N., Liu, Z., Shu, C., & Flores, M.
Affiliations: Cambridge Health Alliance (US)
Harvard Medical School/Cambridge Health Alliance, Department of Psychiatry, Cambridge, Massachusetts
Southwest University (CN)
Harvard University (US)
Brown University (US)
ORCID: Cook, Benjamin Lê
Kafali, E. Nilay
Liu, Zimin
Shu, Chang
Flores, Michael
Venue: JAMA
Publisher: American Medical Association (AMA)
Published: 2014-01-08
Volume: 311
Issue: 2
Pages: 172
ISSN: 0002-9955 (ISSN-L)
0098-7484
DOI: 10.1001/jama.2013.284985
PMC: PMC5555156
OpenAlex: W2028087632
Cited by: 519
References: 46
Citations by year: 2026: 17 · 2025: 32 · 2024: 21 · 2023: 38 · 2022: 59 · 2021: 46 · 2020: 54 · 2019: 59 · 2018: 47 · 2017: 46 · 2016: 44 · 2015: 35 · 2014: 18
FWCI: 31.69
Type: journal article
Language: en
Open access: green
www.ncbi.nlm.nih.gov
Locations: JAMA (publishedVersion)
PubMed (publishedVersion)
PubMed Central (acceptedVersion)
Funders: National Institutes of Health (5r01mh091042-02)
National Institute on Aging (T32AG023482)
National Institute of Mental Health (R01-MH091042)
Topics: Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Smoking Behavior and Cessation
Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
Health Sciences › Medicine › Psychiatry and Mental health › Mental Health Treatment and Access
Keywords: smoking, tobacco use, mental illness, smoking cessation, psychotherapy, nicotine dependence, tobacco use trends, depression, psychological distress, tobacco cessation interventions, tobacco control, adults with mental illness, tobacco harm reduction
MeSH terms: Adolescent, Adult, Aged, Mental Disorders, Female, Health Surveys, Humans, Male, Mental Health, Middle Aged, Smoking, Social Control, Formal, Tobacco Use Disorder, United States, Prevalence, Smoking Cessation, Young Adult

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Trends in Smoking Among Adults With Mental Illness and Association Between Mental Health Treatment and Smoking Cessation

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