Masaki Fujiwara1, Masatoshi Inagaki2, Naoki Nakaya3, Maiko Fujimori4, Yuji Higuchi5, Kyoko Kakeda6, Yosuke Uchitomi7, Norihito Yamada8. 1. Department of Neuropsychiatry, Okayama University Hospital, Okayama, Japan. 2. Department of Psychiatry, Faculty of Medicine, Shimane University, Izumo, Japan. Electronic address: minagaki@med.shimane-u.ac.jp. 3. Department of Preventive Medicine and Epidemiology, Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan. 4. Division of Cohort Consortium Research, Epidemiology and Prevention Group, Center for Public Health Sciences, National Cancer Center, Tokyo, Japan; Division of Health Care Research, QOL Research Group, Center for Public Health Sciences, National Cancer Center, Tokyo, Japan. 5. Department of Psychiatry, Taiyo Hills Hospital, Takahashi, Japan. 6. Department of Neuropsychiatry, Kochi Medical School, Kochi University, Nankoku, Japan. 7. Innovation Center for Supportive, Palliative and Psychosocial Care, National Cancer Center Hospital, Tokyo, Japan; Department of Psycho-Oncology, National Cancer Center Hospital, Tokyo, Japan; Center for Public Health Sciences, National Cancer Center, Tokyo, Japan. 8. Department of Neuropsychiatry, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Science, Okayama, Japan.
Abstract
BACKGROUND: Smoking behavior among people with serious psychological distress (SPD) has not been fully investigated in Asia, although smoking has become a public health concern worldwide. Many Western population-based studies indicate that people with psychological distress are more likely to smoke. METHODS: This study used a national representative data set from the 2010 Comprehensive Survey of Living Conditions of Japan. SPD was defined as scores ≥13 or greater on the Kessler Psychological Distress Scale (K6). Multivariate logistic regression analyses were conducted to analyze the association between SPD and current smoking in Japanese adults. RESULTS: In both men (n = 27,937) and women (n = 30,786), SPD was significantly associated with current smoking (adjusted odds ratios [95% confidence intervals]: 1.169 [1.030-1.328] for men and 1.677 [1.457-1.931] for women). Among men, SPD was significantly associated with current smoking only in people aged ≥50 years (1.519 [1.232-1.874]) and married (1.456 [1.228-1.728]). SPD was significantly associated with current smoking in women of all ages. SPD had a greater impact on current smoking for women aged 20-49 years than for those aged ≥50 years (1.832 [1.552-2.162] and 1.445 [1.099-1.900], respectively). LIMITATIONS: The cross-sectional design precludes assumptions about the direction of causality. In addition, smoking status was self-reported. CONCLUSIONS: SPD was significantly associated with current smoking in Japan and the association was much stronger for younger women. Clinical strategies are needed to reduce the prevalence of smoking among people with SPD to reduce excess mortality in this population.
BACKGROUND: Smoking behavior among people with serious psychological distress (SPD) has not been fully investigated in Asia, although smoking has become a public health concern worldwide. Many Western population-based studies indicate that people with psychological distress are more likely to smoke. METHODS: This study used a national representative data set from the 2010 Comprehensive Survey of Living Conditions of Japan. SPD was defined as scores ≥13 or greater on the Kessler Psychological Distress Scale (K6). Multivariate logistic regression analyses were conducted to analyze the association between SPD and current smoking in Japanese adults. RESULTS: In both men (n = 27,937) and women (n = 30,786), SPD was significantly associated with current smoking (adjusted odds ratios [95% confidence intervals]: 1.169 [1.030-1.328] for men and 1.677 [1.457-1.931] for women). Among men, SPD was significantly associated with current smoking only in people aged ≥50 years (1.519 [1.232-1.874]) and married (1.456 [1.228-1.728]). SPD was significantly associated with current smoking in women of all ages. SPD had a greater impact on current smoking for women aged 20-49 years than for those aged ≥50 years (1.832 [1.552-2.162] and 1.445 [1.099-1.900], respectively). LIMITATIONS: The cross-sectional design precludes assumptions about the direction of causality. In addition, smoking status was self-reported. CONCLUSIONS: SPD was significantly associated with current smoking in Japan and the association was much stronger for younger women. Clinical strategies are needed to reduce the prevalence of smoking among people with SPD to reduce excess mortality in this population.