The relationship between smoking status and serious psychological distress: findings from the 2007 Behavioral Risk Factor Surveillance System.

Objectives: To examine the associations between smoking and quit attempts with psychological distress and also by socioeconomic groups.

Methods: Using data on 172,938 adult respondents from the 2007 Behavioral Risk Factor Surveillance System we used the Kessler-6 scale to assess psychological distress among never, former, some-day, and everyday smokers and smokers attempting to quit.

Results: Everyday smokers and attempting quitters had higher mean levels of 30-day psychological distress than never smokers. Compared with never smokers, the odds of having serious psychological distress (SPD) were: former smokers, 1.3 (95 % CI: 1.1-1.6); some-day smokers, 2.5 (95 % CI: 2.0-3.1); and everyday smokers, 3.3 (95 % CI: 2.8-3.8). As for unsuccessful quit attempts, the odds were highest for current smokers (3.3 [95 % CI: 2.8-3.8]) versus never smokers. Among current smokers, persons with less than high school education, income less than $ 50,000, or who were unemployed or unable to work had the highest odds of reporting SPD.

Conclusions: Given the association between current smoking behaviors and psychological distress, future tobacco prevention and control efforts may benefit by including components of mental health, especially for low SES populations.