Serious Stress May Lead People to Turn to Tobacco

Serious psychological distress affected male and female tobacco users differently

/ Author:  / Reviewed by: Joseph V. Madia, MD Beth Bolt, RPh

(RxWiki News) Tobacco use remains one of the most preventable causes of illness and death in the United States each year. It seems that some adults may be driven to using tobacco by serious stress.

<--break->According to a new study, adults experiencing psychological stress were more likely to use tobacco products. In addition to cigarettes, these tobacco products included cigars and smokeless tobacco.

The study also showed women were more likely than men to use tobacco products after experiencing psychological stress.

"Seek professional help if you are struggling to quit smoking."

This study was led by Mary Hrywna, MPH, of the Center for Tobacco Studies at Rutgers School of Public Health.

According to Hrywna and colleagues, tobacco use remains one of the most preventable causes of premature illness and death in the United States each year. Cigarette smoking and the use of other tobacco products like cigars and smokeless tobacco goods are responsible for nearly one out of every four American deaths and have been directly linked to cardiovascular and respiratory diseases, cancer and negative reproductive effects for both men and women.

Hrywna and team noted that individuals with mental illnesses use tobacco products more often than others, and that individuals who have some form of mental illness, such as depression, anxiety or psychological distress, “consume an estimated 44.3 percent of the cigarettes in the U.S.” each year.

Depression, anxiety and psychological distress affect women at a higher rate than men. Because tobacco use is higher among those with mental health issues, women may be overrepresented among tobacco users with mental health diagnoses, the researchers wrote.

Past research has shown that it is much harder for women to quit smoking than it is for men. The researchers noted that there has not been enough research on how a person's gender affects the relationship between mental health and overall tobacco use, including tobacco products other than cigarettes. They believe that "further research, in particular, sex-specific analyses, is critical to improve understanding of these variables on women."

For the current study, the researchers gathered data from 26,907 adult participants in the 2010 National Health Interview Survey (NHIS). The NHIS asked questions about various types of tobacco use. Study participants also answered questions regarding their levels of psychological stress within the past month, and whether they had experienced any symptoms of depression, such as anxiety, hopelessness and worthlessness.

Compared to those without serious psychological distress, adults with serious psychological distress were more likely to be women, 45 to 64 years old, African American than other races, unmarried and to have at least a high school education.

Those with serious psychological distress also were more likely to report an annual household income of less than $35,000 per year.

“Overall, 3.3 percent of adult participants in the U.S. were found to have serious psychological distress in the preceding month,” the researchers wrote. Both current and long-term use of tobacco was reported at higher levels for those who had experienced some form of psychological stress.

The researchers found that those with serious psychological distress had twice the odds of being current cigarette users compared to those without serious psychological distress. Additionally, participants that had severe psychological distress were 61 percent more likely to be current cigar users, and 21 percent more likely to be current smokeless tobacco users.

Women who had experienced some level of psychological stress not only used more tobacco products, but also had greater odds of using smokeless tobacco and cigars than women who were not stressed. The researchers were surprised by this finding, as previous research suggested that cigars and smokeless tobacco were more commonly used by men than by women.

According to Hrywna and team, their study “adds to the existing research on mental health and smoking by examining the role of sex in the relationship between [serious psychological distress] and tobacco use, including non-cigarette tobacco products, in a nationally representative sample.”

The researchers also noted that organizers of smoking cessation programs may want to modify interventions towards women and assess a smoker’s overall mental health when providing routine and clinical treatments.

This study was published June 18 in the American Journal of Health Behavior

This research was supported by a supplement to National Cancer Institute/National Institutes of Health Cancer Center Support Grant to advance research on cancer in women. The authors declared no conflicts of interest.

Review Date: 
June 24, 2014
Last Updated:
June 26, 2014