Thursday, September 28, 2023
| Characteristic | Current cigarette smokinga | ||||||
|---|---|---|---|---|---|---|---|
| No past-year mental health condition (n = 6,896) | Past-year any mental illnessb (n = 3,983) | Past-year serious mental illness (n = 1,336) | Past-year mild or moderate mental illness (n = 2,647) | Past-year serious psychological distress alone (n = 1,498) | Past-year major depressive disorder alone (n = 303) | Past-year serious psychological distress and major depressive disorder (n = 1,337) | |
| Overall | 13.6 (13.0–14.3) | 22.8 (21.7–23.8) | 27.2 (25.3–29.0) | 21.2 (19.8–22.6) | 24.5 (22.3–26.7) | 17.6 (13.8–21.5) | 25.0 (23.3–26.8) |
| Survey year | |||||||
| 2019 | 14.6 (14.0–15.2) | 25.2 (24.3–26.2) | 30.1 (27.7–32.6) | 23.6 (22.4–24.8) | 27.7 (25.7–29.6) | 18.5 (15.6–21.4) | 27.2 (25.3–29.2) |
| 2020 | 12.7 (11.7–13.7) | 20.3 (18.4–22.1) | 24.3 (20.9–27.7) | 18.9 (16.3–21.4) | 21.3 (17.3–25.3) | 16.7 (9.4–24.0) | 22.9 (20.0–25.9) |
| Age, y | |||||||
| 18–25 | 9.7 (8.9–10.5) | 14.9 (13.8–16.0) | 18.9 (16.6–21.2) | 13.1 (11.8–14.5) | 14.3 (12.4–16.3) | 10.6 (7.6–13.6) | 16.2 (14.1–18.3) |
| 26–34 | 16.5 (15.6–17.4) | 26.1 (24.4–27.9) | 31.6 (27.9–35.4) | 24.1 (22.3–26.0) | 26.7 (23.3–30.1) | 25.1 (15.7–34.6) | 30.2 (26.2–34.1) |
| 35–49 | 17.4 (16.4–18.3) | 27.8 (26.0–29.6) | 34.4 (30.5–38.3) | 25.3 (23.3–27.4) | 31.6 (28.0–35.2) | 21.5 (15.9–27.2) | 32.1 (27.9–36.3) |
| 50–64 | 15.7 (14.4–17.1) | 27.0 (23.4–30.6) | 27.0 (21.6–32.3) | 27.0 (22.3–31.7) | 32.1 (22.3–41.9) | 15.9 (10.1–21.7) | 28.7 (22.2–35.1) |
| ≥65 | 7.7 (6.7–8.8) | 11.6 (8.4–14.7) | — c | 11.8 (8.3–15.4) | 18.1 (8.8–27.4) | — c | 11.8 (4.9–18.6) |
| Sex | |||||||
| Male | 15.8 (15.0–16.6) | 25.5 (23.8–27.1) | 29.1 (26.0–32.1) | 24.3 (22.2–26.3) | 30.1 (26.2–34.0) | 16.4 (12.2–20.6) | 28.0 (25.0–31.0) |
| Female | 11.4 (10.6–12.2) | 21.2 (19.8–22.5) | 26.1 (23.6–28.6) | 19.4 (17.6–21.2) | 20.7 (18.7–22.7) | 18.4 (13.0–23.7) | 23.3 (20.8–25.9) |
| Sexual orientation | |||||||
| Heterosexual | 13.4 (12.7–14.0) | 22.1 (21.0–23.3) | 27.1 (24.9–29.3) | 20.6 (19.1–22.2) | 24.1 (21.8–26.3) | 18.1 (13.9–22.2) | 24.7 (22.8–26.6) |
| Gay/lesbian | 20.7 (16.1–25.2) | 29.2 (23.8–34.6) | 29.3 (19.1–39.5) | 29.2 (21.6–36.7) | 29.4 (20.6–38.2) | — c | 31.3 (21.0–41.7) |
| Bisexual | 22.3 (19.5–25.0) | 25.9 (22.9–28.9) | 28.5 (24.9–32.2) | 23.9 (20.0–27.8) | 26.8 (22.4–31.2) | 17.1 (9.6–24.5) | 25.4 (21.6–29.1) |
| Race/ethnicity | |||||||
| Hispanic | 8.5 (7.6–9.4) | 19.0 (16.0–22.1) | 23.2 (17.8–28.5) | 17.7 (14.1–21.3) | 21.7 (14.7–28.8) | 12.8 (6.1–19.5) | 18.6 (14.2–22.9) |
| Non-Hispanic American Indian, Alaska Native | 26.0 (18.8–33.2) | 53.3 (40.5–66.2) | 59.2 (34.5–83.8) | 50.8 (33.8–67.8) | 71.0 (50.1–92.0) | — c | 40.8 (19.2–62.4) |
| Non-Hispanic Asian | 7.2 (5.1–9.2) | 7.9 (4.5–11.3) | — c | 8.1 (4.2–11.9) | 6.0 (2.8–9.2) | — c | — c |
| Non-Hispanic Black | 16.2 (14.2–18.2) | 21.0 (16.9–25.0) | 17.4 (11.0–23.9) | 22.1 (17.6–26.6) | 24.8 (18.7–30.9) | — c | 15.9 (10.5–21.4) |
| Non-Hispanic multiple races | 23.4 (18.1–28.6) | 29.1 (22.6–35.5) | 32.5 (22.8–42.3) | 27.9 (19.3–36.4) | 22.8 (11.9–33.7) | 23.0 (10.1–35.9) | 26.4 (18.5–34.4) |
| Non-Hispanic Native Hawaiian, Pacific Islander | 13.5 (8.3–18.7) | — c | — c | — c | — c | — c | — c |
| Non-Hispanic White | 14.8 (13.9–15.7) | 24.1 (22.8–25.3) | 29.6 (27.4–31.9) | 22.1 (20.4–23.8) | 26.0 (23.4–28.6) | 18.6 (13.8–23.5) | 28.0 (26.2–29.9) |
| Education | |||||||
| Less than high school diploma | 21.1 (19.2–23.1) | 36.3 (31.2–41.4) | 46.3 (37.0–55.5) | 33.8 (28.2–39.3) | 33.2 (24.8–41.7) | — c | 41.6 (33.6–49.7) |
| High school diploma/GED | 19.0 (17.5–20.4) | 32.3 (29.5–35.2) | 33.0 (28.4–37.7) | 32.0 (28.7–35.4) | 37.7 (33.2–42.3) | 29.8 (20.4–39.3) | 31.5 (26.9–36.1) |
| Some college/associates degree | 14.8 (13.8–15.8) | 23.1 (21.6–24.6) | 26.3 (23.5–29.1) | 21.7 (19.6–23.9) | 22.2 (19.1–25.4) | 16.8 (12.5–21.0) | 24.2 (21.5–27.0) |
| College graduate | 5.6 (5.1–6.2) | 10.5 (9.3–11.7) | 16.9 (14.2–19.5) | 8.7 (7.6–9.9) | 9.6 (7.5–11.8) | 10.1 (6.5–13.8) | 14.7 (12.1–17.4) |
| Disabilityd | |||||||
| Yes | 15.4 (13.5–17.3) | 26.7 (24.9–28.5) | 29.8 (26.8–32.7) | 24.9 (22.5–27.4) | 27.8 (24.5–31.0) | 23.1 (15.6–30.6) | 29.6 (26.5–32.8) |
| No | 13.3 (12.7–13.9) | 19.8 (18.5–21.2) | 23.9 (21.0–26.7) | 18.9 (17.2–20.6) | 22.7 (20.1–25.4) | 13.9 (10.5–17.3) | 19.8 (17.6–21.9) |
| Annual household income | |||||||
| Income at or below federal poverty threshold | 22.5 (20.4–24.7) | 36.7 (33.6–39.7) | 37.6 (32.0–43.2) | 36.2 (32.5–40.0) | 36.8 (31.3–42.3) | 24.8 (14.5–35.1) | 35.9 (31.0–40.9) |
| Income up to 2x federal poverty threshold | 18.5 (16.9–20.1) | 28.1 (25.9–30.4) | 32.4 (28.1–36.7) | 26.6 (23.7–29.4) | 26.9 (22.9–30.8) | 27.8 (15.8–39.9) | 29.6 (26.2–33.1) |
| Income more than 2x federal poverty threshold | 10.9 (10.3–11.5) | 17.0 (15.9–18.1) | 21.4 (19.0–23.8) | 15.6 (14.3–16.9) | 19.4 (16.5–22.3) | 12.9 (9.9–15.9) | 19.5 (17.2–21.9) |
| Marriage status | |||||||
| Married/living with partner | 10.0 (9.2–10.8) | 17.7 (15.9–19.5) | 22.1 (18.6–25.6) | 16.4 (14.5–18.4) | 21.2 (17.1–25.4) | 15.7 (9.9–21.5) | 20.3 (16.9–23.8) |
| Divorced/separated/widowed | 19.6 (17.7–21.6) | 30.2 (27.9–32.6) | 36.7 (32.1–41.3) | 27.8 (24.9–30.7) | 35.8 (29.3–42.3) | 21.1 (14.8–27.4) | 37.9 (32.6–43.3) |
| Never married | 17.1 (16.1–18.1) | 23.4 (22.2–24.6) | 25.9 (23.3–28.4) | 22.4 (20.9–23.9) | 22.4 (20.4–24.4) | 17.5 (12.4–22.6) | 22.5 (20.4–24.7) |
| Health insurancee | |||||||
| Public | 18.5 (16.9–20.1) | 31.6 (29.2–33.9) | 32.7 (28.8–36.6) | 31.1 (27.9–34.2) | 32.7 (28.9–36.4) | 26.5 (15.8–37.1) | 31.7 (27.9–35.5) |
| Private | 10.5 (9.9–11.1) | 15.7 (14.6–16.8) | 19.8 (17.1–22.4) | 14.5 (13.2–15.8) | 17.3 (14.4–20.2) | 13.1 (10.3–15.9) | 17.3 (15.0–19.6) |
| Uninsured | 23.1 (21.2–25.0) | 37.7 (34.4–40.9) | 43.8 (37.3–50.3) | 35.2 (31.5–38.9) | 37.7 (32.9–42.5) | 24.8 (12.7–36.9) | 40.0 (34.6–45.4) |
| Employment status | |||||||
| Full time | 14.4 (13.7–15.2) | 20.5 (19.1–22.0) | 25.6 (23.3–27.9) | 19.0 (17.3–20.6) | 22.0 (19.4–24.7) | 16.0 (11.2–20.9) | 23.7 (21.1–26.2) |
| Part time | 11.6 (10.3–12.9) | 16.4 (14.4–18.4) | 20.0 (15.7–24.3) | 15.1 (12.9–17.2) | 14.6 (10.9–18.3) | 13.8 (8.4–19.3) | 17.9 (14.0–21.8) |
| Unemployed | 23.3 (20.3–26.2) | 35.7 (31.3–40.1) | 36.8 (27.6–46.1) | 35.2 (29.6–40.8) | 35.4 (29.3–41.4) | 29.2 (13.7–44.6) | 32.2 (25.9–38.4) |
| Other/not in labor force | 12.1 (11.1–13.2) | 26.3 (23.6–28.9) | 30.3 (26.6–34.1) | 24.8 (21.4–28.1) | 30.2 (25.2–35.3) | 19.1 (11.1–27.1) | 28.8 (24.9–32.7) |
| Metropolitan statistical areaf | |||||||
| Large metro | 11.6 (10.8–12.4) | 19.3 (18.0–20.7) | 22.9 (20.1–25.8) | 18.2 (16.4–20.0) | 20.7 (17.3–24.0) | 16.7 (10.4–23.1) | 20.4 (17.8–23.1) |
| Small metro | 15.5 (14.5–16.5) | 24.6 (22.7–26.4) | 30.1 (26.9–33.3) | 22.4 (19.8–25.0) | 26.6 (22.8–30.3) | 16.3 (12.3–20.3) | 28.3 (25.3–31.3) |
| Nonmetro/rural | 17.6 (16.2–18.9) | 31.3 (28.3–34.3) | 34.0 (28.4–39.5) | 30.3 (26.7–34.0) | 33.9 (29.2–38.7) | 24.4 (15.6–33.3) | 33.2 (27.8–38.7) |
| Arrested and booked in past 12 months | |||||||
| Yes | 44.1 (38.9–49.2) | 63.0 (56.8–69.2) | 69.9 (60.8–78.9) | 59.3 (51.4–67.2) | 66.2 (53.2–79.2) | 70.2 (43.4–96.9) | 62.1 (52.1–72.1) |
| No | 30.3 (28.8–31.8) | 40.5 (38.2–42.7) | 41.5 (36.1–46.8) | 40.0 (37.2–42.8) | 47.4 (42.0–52.7) | 21.2 (15.7–26.6) | 44.7 (38.5–51.0) |
Table 1. Percentage of Adults Who Currently Smoke Cigarettes, by Mental Health Condition, National Survey on Drug Use and Health, 2019–2020
Abbreviations: GED, General Educational Development.
a Current cigarette smoking was defined as respondents who smoked ≥100 cigarettes in their lifetime and reported smoking part or all of a cigarette in the 30 days preceding interview. Values are weighted percentage (95% CI).
b Past year any mental illness was defined as respondents who reported serious, moderate, or mild mental illness, serious psychological distress, or a major depressive disorder in the past year.
c Estimates suppressed because relative standard error was >30%.
d Disability was defined as respondents reporting any of the following: deaf or difficulty hearing; blind or serious difficulty seeing, even when wearing glasses; serious difficulty concentrating, remembering, or making decisions because of a physical, mental, or emotional condition; serious difficulty walking or climbing stairs; difficulty dressing or bathing; difficulty doing errands alone such as visiting a doctor’s office or shopping because of a physical, mental, or emotional condition.
e Public and private health insurances are not mutually exclusive; public insurance includes Medicaid, Child Health Improvement Plan, Medicare, Tricare, Champus, Veterans Administration, or some other military insurance.
f Metropolitan statistical areas are based on the 2013 Rural–Urban Continuum Codes (www.ers.usda.gov/data-products/rural-urban-continuum-codes.aspx).
| State | AMIb | AMI and smoke cigarettesb,c | No AMI and smoke cigarettesc,d |
|---|---|---|---|
| State median, % | 21.4 | 24.7 | 16.0 |
| Alabama | 20.5 (16.7–25.0) | 35.0 (25.8–45.6) | 19.9 (15.4–25.4) |
| Alaska | 21.1 (17.5–25.3) | 22.5 (15.5–31.6) | 16.4 (13.0–20.4) |
| Arizona | 24.1 (20.7–27.8) | 16.4 (11.2–23.4) | 12.6 (9.2–17.1) |
| Arkansas | 22.3 (18.3–26.9) | 35.3 (26.8–44.8) | 18.3 (14.1–23.3) |
| California | 20.1 (18.6–21.7) | 19.1 (16.0–22.6) | 11.2 (9.6–13.0) |
| Colorado | 23.3 (19.9–27.0) | 20.7 (14.7–28.3) | 12.2 (9.3–15.9) |
| Connecticut | 15.9 (13.1–19.2) | 18.6 (12.7–26.3) | 11.3 (8.0–15.8) |
| Delaware | 20.8 (17.3–24.7) | 24.2 (18.4–31.1) | 17.0 (12.6–22.4) |
| District of Columbia | 23.7 (20.2–27.7) | 19.8 (13.6–27.8) | 18.2 (13.5–24.2) |
| Florida | 16.9 (15.2–18.7) | 23.1 (18.8–28.0) | 15.9 (13.9–18.2) |
| Georgia | 15.7 (13.2–18.5) | 20.0 (14.1–27.6) | 15.3 (12.4–18.8) |
| Hawaii | 17.9 (14.6–21.8) | 22.6 (15.5–31.8) | 15.6 (12.0–20.1) |
| Idaho | 24.9 (21.5–28.6) | 21.1 (15.3–28.3) | 11.8 (8.2–16.7) |
| Illinois | 20.1 (18.0–22.4) | 23.9 (19.1–29.3) | 15.3 (13.2–17.8) |
| Indiana | 20.6 (17.2–24.5) | 35.0 (28.6–42.0) | 20.1 (16.1–24.9) |
| Iowa | 19.7 (16.0–24.0) | 26.4 (19.4–34.9) | 17.7 (13.5–22.8) |
| Kansas | 28.5 (24.3–33.1) | 25.4 (17.9–34.6) | 16.3 (12.3–21.5) |
| Kentucky | 21.6 (18.1–25.6) | 34.2 (26.5–42.9) | 22.3 (18.2–26.9) |
| Louisiana | 21.1 (17.8–24.9) | 42.1 (32.2–52.7) | 20.2 (16.4–24.5) |
| Maine | 22.0 (17.6–27.1) | 23.8 (15.7–34.4) | 15.0 (10.9–20.4) |
| Maryland | 16.6 (14.1–19.5) | 23.4 (17.6–30.3) | 11.5 (8.8–14.8) |
| Massachusetts | 21.4 (17.2–26.3) | 18.6 (10.8–30.2) | 11.7 (9.6–14.2) |
| Michigan | 22.7 (20.3–25.4) | 27.9 (23.7–32.6) | 18.1 (15.5–21.2) |
| Minnesota | 23.6 (20.8–26.7) | 28.4 (21.3–36.8) | 10.5 (8.4–13.2) |
| Mississippi | 22.1 (18.4–26.3) | 32.4 (22.8–43.7) | 22.6 (18.5–27.4) |
| Missouri | 19.8 (17.0–22.9) | 29.6 (23.2–36.9) | 16.4 (13.2–20.1) |
| Montana | 23.0 (18.8–27.9) | 28.6 (21.3–37.1) | 19.1 (16.4–22.1) |
| Nebraska | 23.0 (20.1–26.2) | 30.5 (21.4–41.3) | 12.3 (9.5–15.9) |
| Nevada | 21.2 (17.2–25.9) | 26.7 (19.7–35.1) | 11.9 (8.9–15.9) |
| New Hampshire | 26.3 (22.1–31.0) | 22.0 (15.7–29.9) | 13.8 (10.7–17.6) |
| New Jersey | 17.8 (15.1–20.8) | 17.9 (12.8–24.5) | 12.1 (9.7–15.1) |
| New Mexico | 21.6 (17.6–26.1) | 25.2 (18.6–33.1) | 15.5 (10.8–21.8) |
| New York | 18.7 (17.0–20.6) | 25.6 (21.6–30.0) | 14.0 (12.2–15.9) |
| North Carolina | 18.6 (16.8–20.6) | 27.0 (20.7–34.3) | 17.9 (15.3–20.8) |
| North Dakota | 18.8 (16.2–21.8) | 29.0 (21.2–38.2) | 18.6 (14.6–23.4) |
| Ohio | 24.8 (22.1–27.7) | 34.2 (29.2–39.5) | 19.1 (16.5–22.1) |
| Oklahoma | 29.1 (25.2–33.3) | 28.7 (22.0–36.5) | 21.4 (17.0–26.5) |
| Oregon | 27.5 (23.7–31.7) | 21.5 (15.3–29.3) | 13.8 (10.8–17.4) |
| Pennsylvania | 19.5 (16.9–22.3) | 29.5 (23.1–36.8) | 18.9 (15.5–22.8) |
| Rhode Island | 23.9 (20.2–28.1) | 20.8 (13.3–31.0) | 16.2 (12.1–21.4) |
| South Carolina | 23.3 (19.5–27.5) | 24.7 (18.7–31.9) | 19.9 (16.8–23.5) |
| South Dakota | 18.4 (15.7–21.5) | 28.6 (19.5–39.8) | 19.4 (14.5–25.5) |
| Tennessee | 19.6 (16.2–23.6) | 32.2 (25.3–40.0) | 18.0 (14.1–22.7) |
| Texas | 17.5 (15.7–19.4) | 23.0 (18.9–27.7) | 14.7 (12.9–16.6) |
| Utah | 31.5 (27.8–35.5) | 11.7 (7.9–17.1) | 7.8 (6.1–10.0) |
| Vermont | 22.8 (19.1–26.9) | 27.4 (20.2–36.0) | 10.4 (8.0–13.5) |
| Virginia | 20.4 (17.8–23.4) | 18.9 (13.7–25.5) | 15.2 (12.4–18.4) |
| Washington | 26.1 (22.4–30.1) | 20.1 (15.1–26.3) | 15.4 (12.3–19.0) |
| West Virginia | 28.3 (24.1–32.9) | 31.6 (23.2–41.4) | 20.7 (16.2–26.2) |
| Wisconsin | 21.1 (18.2–24.2) | 22.1 (16.9–28.3) | 16.0 (12.0–20.9) |
| Wyoming | 24.1 (20.3–28.3) | 25.1 (17.7–34.1) | 19.7 (14.7–25.9) |
Table 2. Percentage of Adults Who Currently Smoke Cigarettes, by State and Mental Illness Status, National Survey on Drug Use and Health, 2019–2020a
Abbreviation: AMI, any mental illness.
a Values are weighted percentage (95% CI) unless otherwise indicated.
b Any mental illness was defined as a participant who reported serious, moderate, or mild mental illness, serious psychological distress, and/or major depressive disorder in the past year.
c Current cigarette smoking was defined as those reporting smoking part or all of a cigarette in the past 30 days before interview.
d No serious, moderate, or mild mental illness, serious psychological distress, or major depressive episode reported over the past year.
Medscape, LLC requires every individual in a position to control educational content to disclose all financial relationships with ineligible companies that have occurred within the past 24 months. Ineligible companies are organizations whose primary business is producing, marketing, selling, re-selling, or distributing healthcare products used by or on patients.
All relevant financial relationships for anyone with the ability to control the content of this educational activity are listed below and have been mitigated. Others involved in the planning of this activity have no relevant financial relationships.
Health Sciences Clinical Professor of Family Medicine
University of California, Irvine School of Medicine
Physicians - maximum of 1.00 AMA PRA Category 1 Credit(s)™
ABIM Diplomates - maximum of 1.00 ABIM MOC points
This activity is intended for primary care physicians, psychiatrists, addiction medicine specialists, and other healthcare professionals who see patients who smoke cigarettes.
The goal of this activity is for learners to be better able to assess the problem of cigarette smoking among US adults with mental illness.
Upon completion of this activity, participants will:
Medscape, LLC requires every individual in a position to control educational content to disclose all financial relationships with ineligible companies that have occurred within the past 24 months. Ineligible companies are organizations whose primary business is producing, marketing, selling, re-selling, or distributing healthcare products used by or on patients.
All relevant financial relationships for anyone with the ability to control the content of this educational activity are listed below and have been mitigated. Others involved in the planning of this activity have no relevant financial relationships.
Health Sciences Clinical Professor of Family Medicine
University of California, Irvine School of Medicine
Medscape, LLC designates this Journal-based CME for a maximum of 1.0 AMA PRA Category 1 Credit(s)™ . Physicians should claim only the credit commensurate with the extent of their participation in the activity.
Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to 1.0 MOC points in the American Board of Internal Medicine's (ABIM) Maintenance of Certification (MOC) program. Participants will earn MOC points equivalent to the amount of CME credits claimed for the activity. It is the CME activity provider's responsibility to submit participant completion information to ACCME for the purpose of granting ABIM MOC credit.
For questions regarding the content of this activity, contact the accredited provider for this CME/CE activity noted above. For technical assistance, contact [email protected]
There are no fees for participating in or receiving credit for this online educational activity. For information on applicability
and acceptance of continuing education credit for this activity, please consult your professional licensing board.
This activity is designed to be completed within the time designated on the title page; physicians should claim only those
credits that reflect the time actually spent in the activity. To successfully earn credit, participants must complete the
activity online during the valid credit period that is noted on the title page. To receive AMA PRA Category 1 Credit™, you must receive a minimum score of 70% on the post-test.
Follow these steps to earn CME/CE credit*:
You may now view or print the certificate from your CME/CE Tracker. You may print the certificate, but you cannot alter it.
Credits will be tallied in your CME/CE Tracker and archived for 6 years; at any point within this time period, you can print
out the tally as well as the certificates from the CME/CE Tracker.
*The credit that you receive is based on your user profile.
CME / ABIM MOC Released: 12/22/2022
Valid for credit through: 12/22/2023, 11:59 PM EST
processing....
Prevalence of cigarette smoking is disproportionally high among US adults with mental health conditions. Adults with mental health conditions who smoke cigarettes are at increased risk for smoking-related illness and death compared with adults without mental health conditions.
We analyzed pooled data from the 2019 and 2020 National Survey on Drug Use and Health to provide national estimates of current cigarette smoking prevalence among US adults aged 18 years or older who reported having in the past year any mental illness, serious mental illness, mild or moderate mental illness, serious psychological distress, and/or major depressive episode (N = 19,398) and state-level estimates for any mental illness.
Prevalence of cigarette smoking for serious mental illness was 27.2%; serious psychological distress and major depressive disorder, 25.0%; serious psychological distress, 24.5%; any mental illness, 22.8%; mild or moderate mental illness, 21.2%; and major depressive disorder, 17.6%. State-level cigarette smoking prevalence among adults with any mental illness ranged from 11.7% in Utah to 42.1% in Louisiana, with a median of 24.7%.
The prevalence of current cigarette smoking is higher among adults with any mental illness, psychological distress, and major depressive disorder than among those without any mental illness, especially among adults who are non-Hispanic American Indian or Alaska Native, Hispanic, lesbian, gay, or bisexual and among those who are experiencing poverty, are uninsured, or have been arrested and booked in the past year. Continued improvement in integration of smoking cessation interventions into mental health treatment, equitable implementation of comprehensive commercial tobacco control policies, and population-specific approaches could reduce cigarette smoking among adults with mental health conditions.
