Smoking and mental illness: results from population surveys in Australia and the United States.
Smoking and mental illness: results from population surveys in Australia and the United States.
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DOI：
10.1186/1471-2458-9-285
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发表时间：
2009-08-07
影响因子：
4.5
通讯作者：
Zubrick SR
中科院分区：
文献类型：
--
作者：
Lawrence D;Mitrou F;Zubrick SR
吸烟与一系列精神障碍有关，包括精神分裂症、焦虑症和抑郁症。患有精神疾病的人患与吸烟有关的疾病（如心血管疾病、呼吸系统疾病和癌症）的发病率和死亡率很高。由于许多符合精神障碍诊断标准的人不寻求治疗，我们试图在最近的人群调查中调查精神疾病和吸烟之间的关系。2001-2003年进行的美国国家共病调查-复制调查数据、2007年澳大利亚心理健康和福祉调查数据以及2007年美国国家健康访谈调查数据被用于调查当前吸烟、ICD-10精神障碍和非特异性心理困扰之间的关系。计算按疾病划分的吸烟率和按吸烟状况划分的精神障碍率的人口加权估计值。在美国和澳大利亚，在调查前的12个月里，符合ICD-10精神障碍标准的成年人的吸烟率几乎是无精神障碍成年人的两倍。虽然大约20%的成年人患有12个月的精神障碍，但在成年吸烟者中，大约三分之一的人患有12个月的精神障碍——美国为31.7% (95% CI: 29.5%-33.8%)，澳大利亚为32.4% （95% CI: 29.5%-35.3%）。女性吸烟者患精神疾病的比率高于男性吸烟者，年轻吸烟者患精神疾病的比率明显高于年长吸烟者。大多数患有精神疾病的吸烟者不与精神卫生服务机构接触，但他们的吸烟率与因其精神卫生问题而获得服务的患有精神疾病的吸烟者的吸烟率没有差别。心理困扰程度高的吸烟者平均每天吸烟的数量更高。精神疾病与较高的吸烟率和吸烟者较高的吸烟率有关。此外，很大一部分吸烟者患有精神疾病。解决精神疾病和吸烟者中的精神疾病吸烟问题的策略似乎是烟草控制的重要方向。由于大多数患有精神疾病的吸烟者没有接触精神卫生服务，因此应对精神疾病的战略应作为以人口健康为基础的精神卫生和烟草控制工作的一部分。
Smoking has been associated with a range of mental disorders including schizophrenia, anxiety disorders and depression. People with mental illness have high rates of morbidity and mortality from smoking related illnesses such as cardiovascular disease, respiratory diseases and cancer. As many people who meet diagnostic criteria for mental disorders do not seek treatment for these conditions, we sought to investigate the relationship between mental illness and smoking in recent population-wide surveys. Survey data from the US National Comorbidity Survey-Replication conducted in 2001–2003, the 2007 Australian Survey of Mental Health and Wellbeing, and the 2007 US National Health Interview Survey were used to investigate the relationship between current smoking, ICD-10 mental disorders and non-specific psychological distress. Population weighted estimates of smoking rates by disorder, and mental disorder rates by smoking status were calculated. In both the US and Australia, adults who met ICD-10 criteria for mental disorders in the 12 months prior to the survey smoked at almost twice the rate of adults without mental disorders. While approximately 20% of the adult population had 12-month mental disorders, among adult smokers approximately one-third had a 12-month mental disorder – 31.7% in the US (95% CI: 29.5%–33.8%) and 32.4% in Australia (95% CI: 29.5%–35.3%). Female smokers had higher rates of mental disorders than male smokers, and younger smokers had considerably higher rates than older smokers. The majority of mentally ill smokers were not in contact with mental health services, but their rate of smoking was not different from that of mentally ill smokers who had accessed services for their mental health problem. Smokers with high levels of psychological distress smoked a higher average number of cigarettes per day. Mental illness is associated with both higher rates of smoking and higher levels of smoking among smokers. Further, a significant proportion of smokers have mental illness. Strategies that address smoking in mental illness, and mental illness among smokers would seem to be important directions for tobacco control. As the majority of smokers with mental illness are not in contact with mental health services for their condition, strategies to address mental illness should be included as part of population health-based mental health and tobacco control efforts.