Cited by 503Smoking Behavior and CessationSubstance Abuse Treatment and OutcomesGlobal Public Health Policies and Epidemiology

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Smoking, Mental Illness, and Public Health

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Prochaska, Judith J., Das, Smita, Young-Wolff, Kelly C.·2017·Annual Review of Public Health

DOI 10.1146/annurev-publhealth-031816-044618PMC PMC5788573

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Abstract

Tobacco use remains the leading preventable cause of death worldwide. In particular, people with mental illness are disproportionately affected with high smoking prevalence; they account for more than 200,000 of the 520,000 tobacco-attributable deaths in the United States annually and die on average 25 years prematurely. Our review aims to provide an update on smoking in the mentally ill. We review the determinants of tobacco use among smokers with mental illness, presented with regard to the public health HAVE framework of “the host” (e.g., tobacco user characteristics), the “agent” (e.g., nicotine product characteristics), the “vector” (e.g., tobacco industry), and the “environment” (e.g., smoking policies). Furthermore, we identify the significant health harms incurred and opportunities for prevention and intervention within a health care systems and larger health policy perspective. A comprehensive effort is warranted to achieve equity toward the 2025 Healthy People goal of reducing US adult tobacco use to 12%, with attention to all subgroups, including smokers with mental illness.

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Γώγος, Α., Σκώκου, Μ., Ferentinou, E., & Gourzis, P. (2019) · Neuropsychiatric Disease and Treatment · doi:10.2147/ndt.s210199 · Cited by 26
Disparities in smoking prevalence and associations with mental health and substance use disorders in underserved communities across the United States
Lin, S. C., Gathua, N., Thompson, C. L., Sripipatana, A., & Makaroff, L. A. (2022) · Cancer · doi:10.1002/cncr.34132 · Cited by 27
Modeling smoking-attributable mortality among adults with major depression in the United States
Tam, J., Taylor, G. M. J., Zivin, K., Warner, K. E., & Meza, R. (2020) · Preventive Medicine · doi:10.1016/j.ypmed.2020.106241 · Cited by 24
Understanding Interactions of Smoking on Prognosis of HPV-Associated Oropharyngeal Cancers
Haigentz, M., Suarez, C. M., Strojan, P., Rodrigo, J. P., Rinaldo, A., Bradford, C. R., Corry, J. F., Takes, R. P., & Ferlito, A. (2018) · Advances in Therapy · doi:10.1007/s12325-018-0682-4 · Cited by 22
Associations Between Nicotine Knowledge and Smoking Cessation Behaviors Among US Adults Who Smoke
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Emotions and lung cancer screening: Prioritising a humanistic approach to care
Olson, R. E., Goldsmith, L. B., Winter, S., Spaulding, E., Dunn, N., Mander, S., Ryan, A., Smith, A., & Marshall, H. (2022) · Health & Social Care in the Community · doi:10.1111/hsc.13945 · Cited by 22
“Smoking is strongly associated with mental health disorders (Prochaska et al., 2017 ) and sadness predicts current smoking as well as smoking relapse (Dorison et al., 2020 ).”
Background
Dynamic associations between anxiety, depression, and tobacco use in older adults: Results from The Irish Longitudinal Study on Ageing
Monroe, D. C., McDowell, C. P., Kenny, R. A., & Herring, M. P. (2021) · Journal of Psychiatric Research · doi:10.1016/j.jpsychires.2021.05.017 · Cited by 24
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Garey, L., Neighbors, C., Leal, I. M., Lam, C. Y., Wilson, W. T., Kyburz, B., Stacey, T., Correa-Fernández, V., Williams, T., Zvolensky, M. J., et al. (2019) · Patient Education and Counseling · doi:10.1016/j.pec.2019.04.013 · Cited by 21
“One explanation for this discrepancy is that smokers with BHCs do not receive the specialized care they need to quit successfully [16].”
Background
An analysis of the relationship between chronic obstructive pulmonary disease, smoking and depression in an integrated healthcare system
Riblet, N. B. V., Gottlieb, D. J., Hoyt, J. E., Watts, B. V., & Shiner, B. R. (2020) · General Hospital Psychiatry · doi:10.1016/j.genhosppsych.2020.03.007 · Cited by 21
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“This worse evolution may favor the association between depression and poorer physical health (Maes et al., 2011) and also chronicize risk behaviors with respect to health habits (Hoare et al., 2016; Mikkelsen et al., 2017; Prochaska et al., 2017; Rajan and Menon, 2017; Roberts and Bailey, 2011).”
BackgroundInfluential
Association between atherogenic index of plasma and depressive symptoms in US adults: Results from the National Health and Nutrition Examination Survey 2005 to 2018
Ye, Z., Huang, W., Li, J., Tang, Y., Shao, K., & Xiong, Y. (2024) · Journal of Affective Disorders · doi:10.1016/j.jad.2024.04.045 · Cited by 21
Delphi consensus on research priorities in tobacco use and substance abuse in Saudi Arabia
Makeen, A. M., Alanazi, A., AlAhmari, M. D., Murriky, A. A., Alfaraj, M., & Al-Zalabani, A. H. (2020) · Journal of Ethnicity in Substance Abuse · doi:10.1080/15332640.2020.1845900 · Cited by 19
“The prevalence of smoking increases with more mental illnesses ranging from 18% in people without any mental condition to 61% in people with 3 or more mental disorders (Prochaska et al., 2017).”
Background
Offering mailed nicotine replacement therapy and Quitline support before elective surgery: a randomised controlled trial
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Culbreth, R. E., Spears, C. A., Brandenberger, K. J., Feresin, R. G., Self‐Brown, S., Goodfellow, L. T., Swahn, M. H., & Gardenhire, D. S. (2021) · Respiratory Care · doi:10.4187/respcare.08381 · Cited by 19
“16,17 Smoking has been conceptualized as an attempt to relieve depression and anxiety symptoms (eg, the self-medication hypothesis), 16,18 although research suggests that smoking cessation can improve mental health in the long term.”
Metal ions in cerebrospinal fluid: Associations with anxiety, depression, and insomnia among cigarette smokers
Li, Y., Wu, F., Mu, Q., Xu, K., Yang, S., Wang, P., Wu, Y., Wu, J., Wang, W., Li, H., et al. (2022) · CNS Neuroscience & Therapeutics · doi:10.1111/cns.13955 · Cited by 19
Depressive symptoms and the age of initiation of tobacco and marijuana use among adolescents and young adults
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One-Year Efficacy and Incremental Cost-effectiveness of Contingency Management for Cigarette Smokers With Depression
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Factors influencing smoking behaviour of online ride-hailing drivers in China: a cross-sectional analysis
Chen, X., Gu, X., Li, T., Liu, Q., Xu, L., Peng, B., & Wu, N. (2021) · BMC Public Health · doi:10.1186/s12889-021-11366-8 · Cited by 18
Organizational Factors Moderating Changes in Tobacco Use Dependence Care Delivery Following a Comprehensive Tobacco-Free Workplace Intervention in Non-Profit Substance Use Treatment Centers
Le, K., Chen, T. A., Leal, I. M., Correa-Fernández, V., Obasi, E. M., Kyburz, B., Williams, T., Casey, K., Taing, M., O’Connor, D. P., et al. (2021) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph181910485 · Cited by 18
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“…pandemic months amongst individuals with previous mental illness; who usually have a higher number of comorbidities (obesity, diabetes, and cardiovascular illnesses) as compared to the general population (Firth et al., 2019), as well as higher prevalences of tobacco use (Prochaska et al., 2017).”
Collaborative Learning: A Qualitative Study Exploring Factors Contributing to a Successful Tobacco Cessation Train-the-Trainer Program as a Community of Practice
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“, mental health and/or substance use disorders) remains at least double that, with prevalence rates ranging from 32 to 67% [2], depending upon specific diagnosis [3].”
Background
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Abufarsakh, B., Okoli, C. T. C., Darville, A. K., Williams, L. B., Garcia, A. R., & Martin, C. A. (2023) · Addictive Behaviors · doi:10.1016/j.addbeh.2023.107948 · Cited by 19
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“While this, to some extent, might be a valid point in certain specific specialties, such as during surgery and in acute care units, in most diseases smoking cessation can have a profound impact on illness progression and treatment outcomes 2,5,19,20 .”
Background
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“First, there is a paucity of TT provided in mental health services and PWS who use tobacco may have affective, cognitive, and social challenges which can impair their engagement in conventional TT in the general population (Prochaska, 2011; Prochaska et al., 2017).”
Background
Cross-Sectional Associations of Multiple Tobacco Product Use with Depressive and Anxiety Symptoms among Young Adult E-Cigarette Users
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“…has established strong bidirectional associations between mental health conditions and cigarette smoking (Boden et al., 2010; Fluharty et al., 2017; Prochaska et al., 2017) and electronic nicotine delivery system (ENDS) use (Bandiera et al., 2016, 2017; Cummins et al., 2014), but few studies…”
Background
Cancer and severe mental illness in low‐ and middle‐income countries: The challenges and outlook for the future
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“Whilst there is a lower incidence of cancer in low‐ and middle‐income countries, cancer‐ related mortality rates are higher.(11) For example, SMI patients who live in low‐ and middle‐income countries may not have access to evidence‐based treatment and opt for alternative ways of care such as traditional medicine or fa…”
Background
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The Social Determinants of Mental Health
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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
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Investigating the shared genetic architecture between attention-deficit/hyperactivity disorder and risk taking behavior: A large-scale genomewide cross-trait analysis
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Adverse Childhood Experiences and Youth Cigarette Use in 2013 and 2016: Emerging Disparities in the Context of Declining Smoking Rates
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‘They’re Going to Smoke Anyway’: A Qualitative Study of Community Mental Health Staff and Consumer Perspectives on the Role of Social and Living Environments in Tobacco Use and Cessation
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“Shared genetic predispositions to both mental illness and tobacco, smoking to manage stress, mental health symptoms and medication side effects, the historic influence of institutionalisation and use of tobacco to control and reward behaviour, normalisation of tobacco and use of tobacco to combat boredom and social is…”
Background
Development of a colloidal gold immunochromatographic strip for rapid and sensitive detection of nicotine
Li, X., Liu, L., Guo, L., Xu, L., Kuang, H., & Xu, C. (2022) · Journal of Pharmaceutical and Biomedical Analysis · doi:10.1016/j.jpba.2022.115132 · Cited by 15
Psychological distress and responses to comparative risk messages about electronic and combusted cigarettes
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“…smoking cessation medications (e.g., nicotine replacement therapy [NRT]) are recommended for all adult smokers interested in quitting (Das & Prochaska, 2017; Stead & Lancaster, 2012), ecigarettes could potentially offer an alternative or a supplementary tool to smokers who have not been…”
Background

Authors: Prochaska, J. J., Das, S., & Young-Wolff, K. C.
Affiliations: Stanford Medicine (US)
Stanford University (US)
Division of Research, Kaiser Permanente Northern California, Oakland, California 94612;
ORCID: Prochaska, Judith J.
Das, Smita
Venue: Annual Review of Public Health
Publisher: Annual Reviews
Published: 2017-03-20
Volume: 38
Issue: 1
Pages: 165-185
ISSN: 0163-7525 (ISSN-L)
1545-2093
DOI: 10.1146/annurev-publhealth-031816-044618
PMC: PMC5788573
OpenAlex: W2520553955
Cited by: 503
References: 135
Citations by year: 2026: 34 · 2025: 51 · 2024: 61 · 2023: 74 · 2022: 70 · 2021: 92 · 2020: 51 · 2019: 36 · 2018: 21 · 2017: 13
FWCI: 2.74
Type: journal article
Language: en
Open access: hybrid
doi.org
Licence: cc-by-sa
creativecommons.org/licenses/by-sa/4.0/ (vor)
Locations: Annual Review of Public Health (publishedVersion, cc-by-sa)
PubMed (publishedVersion)
Europe PMC (PubMed Central) (acceptedVersion, cc-by-sa)
PubMed Central (acceptedVersion, cc-by-sa)
eScholarship (California Digital Library) (submittedVersion)
Funders: National Heart, Lung, and Blood Institute (R01HL117736)
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 › Public Health, Environmental and Occupational Health › Global Public Health Policies and Epidemiology
Keywords: tobacco use, mental illness, smoking prevalence, premature mortality, determinants of tobacco use, nicotine products, tobacco industry, smoking policy, smoking prevention, smoking cessation interventions, health equity, tobacco use reduction
MeSH terms: Mental Disorders, Health Policy, Humans, Public Health, Smoking, United States, Comorbidity, Smoking Cessation, Persons with Psychiatric Disorders

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