Smoking rates drop among those with depression, substance use

A new study indicates a significant decline, and suggests the value of adding cessation programs to behavioral health treatment.

People with depression or struggling with substance abuse are smoking less, according to a new study.

Researchers at the National Institute of Drug Abuse, part of the National Institutes of Health, led the study. The results were published on the JAMA website Tuesday.

The researchers say the findings point to the value of adding smoking cessation programs to behavioral health and substance abuse treatment.

Nora Volkow, NIDA’s director of NIDA and co-author of the study, described the significance of the findings.

“This study shows us that, at a population-level, reductions in tobacco use are achievable for people with psychiatric conditions, and smoking cessation should be prioritized along with treatments for substance use, depression, and other mental health disorders for people who experience them,” Volkow said in a news release accompanying the findings.

Still, the study shows that those with mental health issues and substance use have higher rates of smoking.

Nonetheless, cigarette smoking has been dropping in the general population, which is clearly good news from a public health perspective, since smoking raises the risks of cancer, heart disease and lung diseases. The study shows a decline in smoking among people with psychiatric disorders as well.

The study analyzed data from more than 558,000 adults who participated in National Surveys on Drug Use and Health between 2006 and 2019.

Among adults with a major depressive episode in the previous year, smoking rates declined by 13.1% from 2006 to 2019. Among those without an episode, smoking rates fell by 8.2% in that 14-year span. The study found 11.5% of those with a depressive episode in the past year smoked, while 6.6% of those without such an episode smoked.

Looking at those with substance use disorders, smoking rates fell by 10.9% from 2006 to 2019; smoking rates dropped by 7.8% among adults without the disorder.

Among those with both depression and substance use disorder, smoking rates declined by 13.7% over that period, while smoking dropped by 7.6% among adults without those disorders.

Smoking dropped among men and women and virtually all age, racial and ethnic groups, the study found.

However, smoking rates did not drop among American Indian and Alaska Native adults, a disappointing finding, particularly since they have the highest smoking rates of any racial and ethnic subgroups. They also have the lowest quitting rates, the study found.

The drop in smoking rates in virtually all groups is “a public health success story,” Wilson Compton, NIDA’s deputy director, said in a statement. However, Compton also said it’s important to build on the progress.

“It is crucial that healthcare providers treat all the health issues that a patient experiences, not just their depression or drug use disorder at a given point in time,” Compton said. “To do this, smoking cessation therapies need to be integrated into existing behavioral health treatments.The result will be longer and healthier lives for all people.”

Researchers added further study is needed to evaluate vaping.

And since the study examined trends before the arrival of COVID-19, the researchers said it’s worth investigating to see if the pandemic had any impact on smoking trends.