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Fewer people with mental health, substance use disorders are smoking

(Dave Martin/AP)
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Depression and substance use disorders stereotypically come with a side of smoking.

New data, however, suggests the number of people with mental health and substance use disorders who smoke is falling quickly.

A study in JAMA finds “significant declines” in cigarette smoking among people with depression, substance use disorder or both between 2006 and 2019.

Researchers from the National Institutes of Health and the Substance Abuse and Mental Health Services Administration drew on data from the National Survey on Drug Use and Health, a long-standing survey that interviews thousands of Americans about their mental health, drug use and more. The survey asks participants to self-report whether they smoked within the last month.

There’s a long-standing association between tobacco use and behavioral health disorders. A significantly higher proportion of people with mental health disorders use tobacco compared with those without the disorders, and one 2017 American Lung Association analysis found that 35 percent of all smokers have a mental health condition such as depression, schizophrenia or bipolar disorder.

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The new data, however, suggests that’s changing.

In 2006, 37.3 percent of participants with a diagnosis of major depressive disorder said they had smoked cigarettes within the last month. In 2019, 24.2 percent said they had. Smoking declined from 46.5 percent to 35.8 percent for people with substance use disorder, and from 50.7 to 37 percent for people with both.

“These declines tell a public health success story,” Wilson Compton, deputy director of the National Institute on Drug Abuse and the study’s senior author, said in a news release.

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The decline didn’t apply to everyone: Rates didn’t budge for American Indian and Alaska Native people, who have a much higher prevalence of cigarette smoking — and lung disease — than their counterparts.

Nor did the study include data on people who have been institutionalized or who are experiencing homelessness; the researchers say they want to look into those factors in the future.

In recent years, cigarette use has declined sharply across the nation. In 2005, nearly 21 percent of American adults used cigarettes. In 2020, that number fell to 12.5 percent.