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

Int J Public Health. 2009 Jun;54 Suppl 1:68-74. doi: 10.1007/s00038-009-0009-y.


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.

MeSH terms

  • Adolescent
  • Adult
  • Anxiety Disorders / epidemiology
  • Anxiety Disorders / psychology
  • Behavioral Risk Factor Surveillance System
  • Chronic Disease
  • Comorbidity
  • Humans
  • Middle Aged
  • Mood Disorders / epidemiology
  • Mood Disorders / psychology
  • Smoking / epidemiology*
  • Smoking / psychology*
  • Smoking Cessation / psychology
  • Smoking Cessation / statistics & numerical data
  • Socioeconomic Factors
  • Stress, Psychological / epidemiology*
  • Stress, Psychological / psychology
  • United States / epidemiology
  • Young Adult