Trends in cigarette use, by serious psychological distress status in the United States, 1998-2013.

Abstract Objectives The study compared trends in current and heavy cigarette smoking between adults with and without serious psychological distress (SPD). Methods This study examined data from 480,024 adults aged 18 years or older in the 1998–2013 National Health Interview Survey (NHIS) public use files. SPD is defined as having a Kessler-6 score of 13 or higher in the past month. Trends in the prevalence of current smoking and heavy smoking for 2-year time periods were assessed among those with versus those without SPD using logistic regression; tests of interaction terms determined whether smoking trends differed by SPD status. Results The prevalence of current smoking decreased over time among adults without SPD (adjusted odds ratio [AOR] = 0.97, 95% CI = 0.97–0.98), but remained stable among adults with SPD (AOR = 1.01, 95% CI = 0.99–1.03). Both groups had significant declines in heavy smoking over time; however, the rates of decline were greater among adults without versus with SPD (AOR = 0.87, 95% CI = 0.86–0.88 and AOR = 0.91, 95% CI = 0.88–0.94, respectively). Conclusions The prevalence of current smoking is not declining among adults with SPD, and the prevalence of heavy smoking is not declining as quickly among adults with SPD as compared with those without SPD. Smoking cessation efforts may need to target these populations and tailor programs accordingly.