Cigarette Smoking and Quitting-Related Factors Among US Adult Health Center Patients with Serious Mental Illness
Open accessAbstract
Introduction US adults with serious mental illness (SMI), compared to those without SMI, have a higher prevalence of smoking, which contributes to a shorter life expectancy. This study compared current smoking and quitting-related characteristics of low-income US adults with and without SMI who received healthcare at federally funded health centers.Methods Using cross-sectional data from adults ≥ 18 years old in the nationally representative 2014 Health Center Patient Survey (n = 5592), we compared the prevalence of ever and current smoking among adults with and without SMI and calculated quit ratios as the percentage of ever smokers who have quit smoking. We examined the association between SMI and receiving advice to quit, making quit attempts, and having plans to quit in the next 30 days using multivariable logistic regression.Results A total of 1376 (23%) of participants had SMI. Ever smoking prevalence was 68% in adults with SMI and 41% in adults without SMI, and current smoking prevalence was 48% and 22%, respectively. The quit ratio was 30% and 46% among participants with and without SMI, respectively. Compared to smokers without SMI, more smokers with SMI reported receiving advice to quit in the past 12 months (aOR 2.47, 95% CI 1.20-5.07). Smokers with and without SMI did not differ significantly in their odds of having made a past-12-month quit attempt or plans to quit.Conclusions Smokers with SMI seen in federally funded health centers were just as likely to have made a quit attempt and to have plans to quit as smokers without SMI. Despite a higher likelihood of receiving clinician advice to quit, the lower quit ratio in this population suggests that advice alone is unlikely to be sufficient. These results underscore the need for augmented strategies to promote smoking cessation and reduce the excess burden of tobacco-related disease in patients with SMI.
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Smoking is often not addressed (assessed or integrated into treatment) in mental health treatment facilities.
“There is also widespread evidence that smoking is often not addressed (e.g., assessed or integrated into treatment) in mental health treatment facilities [29, 30].”
From Can an Acceptance and Commitment Therapy-Based Smartphone App Help Individuals with Mental Health Disorders Quit Smoking? (2024) · cites this paper as [29]
The Discussion (page unavailable) reports that an earlier survey found only one-third of patients with bipolar disorder were advised to quit by a mental health provider. That supports a gap in smoking-related advice, but this paper did not determine whether smoking was assessed or integrated into treatment at mental health facilities; its own 87% advice figure combines healthcare professionals without distinguishing psychiatrists from primary care providers. (LLM, conf=0.84)
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“There is also widespread evidence that smoking is often not addressed (e.g., assessed or integrated into treatment) in mental health treatment facilities [29, 30].”
- Authors
- Kalkhoran, S., Thorndike, A. N., Rigotti, N. A., Fung, V., & Baggett, T. P.
- Affiliations
- Harvard University (US)
- Corresponding author
- Kalkhoran, Sara
- Venue
- Journal of General Internal Medicine
- Published
- 2019-02-19
- Volume
- 34
- Issue
- 6
- Pages
- 986-991
- ISSN
- 0884-8734 (ISSN-L)
- 1525-1497
- PMC
- PMC6544702
- OpenAlex
- W2917216304
- Cited by
- 78
- References
- 45
- Citations by year
- 2026: 4 · 2025: 7 · 2024: 6 · 2023: 45 · 2022: 4 · 2021: 6 · 2020: 3 · 2019: 3
- FWCI
- 2.74
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- www.springer.com/tdm (tdm)
- Locations
- Journal of General Internal Medicine (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Massachusetts General Hospital
- Agency for Healthcare Research and Quality (R01 HS025378)
- National Heart, Lung, and Blood Institute (R01HL125486, K23HL136854)
- National Institute on Drug Abuse (K23DA034008)
- National Institute of Diabetes and Digestive and Kidney Diseases (R01DK114735)
- Topics
- Health Sciences › Medicine › Physiology › Smoking Behavior and Cessation
- Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
- Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
- Keywords
- cigarette smoking, smoking cessation, severe mental illness, quit attempts, low-income adults, tobacco-related disease burden
- MeSH terms
- Cigarette Smoking, Smokers, Adolescent, Adult, Ambulatory Care Facilities, Mental Disorders, Cross-Sectional Studies, Female, Health Surveys, Humans, Male, Middle Aged, United States, Smoking Cessation, Young Adult
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