Mental Health Affects Ability to Quit Smoking

Researchers at National Jewish Health have found tobacco quitline participants who identified as having mental health conditions and/or recent emotional challenges are significantly less likely to successfully quit smoking than those without mental health conditions. Additionally, those who believed their mental health condition would negatively affect their quit attempt were significantly less likely to succeed than those who felt it wouldn’t be an issue. The study, done in collaboration with researchers at the University of Colorado, was published in the August 8, 2015, issue of the journal Nicotine & Tobacco Research.

“Over the past several decades we’ve made incredible strides in reducing the smoking rates in the United States, but those successes have not extended to people with mental health conditions,” said Amy Lukowski, PsyD, clinical director of Health Initiatives programs at National Jewish Health and lead author of the study. “This study highlights the importance of evaluating mental health status in individuals seeking support for tobacco cessation. These individuals may need more tailored interventions to ensure better quit outcomes.”

National Jewish Health collected telephone data from more than 26,000 quitline participants across six states. During an initial intake call participants were asked three mental health screening questions: (1) “Do you have any mental health conditions, such as anxiety disorder, depression disorder, bipolar disorder, alcohol or drug abuse or schizophrenia?” (2) During the past two weeks, have you experienced any emotional challenges such as excessive stress, feeling depressed or anxious?” and (3) “During the past two weeks, have you experienced any emotional challenges that have interfered with your work, family life, or social activities?” Answering “yes” to any of the three questions was considered and indicator of mental health conditions for this study. Additionally, if callers responded “yes” to one or more of the questions they were then asked, “Do you believe that these mental health conditions or emotional challenges will interfere with your ability to quit?”

More than 76 percent of quitline callers reported mental health conditions and/or emotional challenges. Thirty-three percent of participants with mental health conditions were tobacco-free at six months compared with 43 percent of those with no mental health conditions.

The success rate among participants who believed that their mental health condition would interfere with their quit attempt was 26 percent at six months compared with a 35 percent success rate of those who felt their quit attempt would not be affected by their mental health condition.

“Though quit rates were higher in callers without mental health issues, a substantial number of callers reporting mental health issues were able to maintain their quit attempt for up to six months after their intervention,” said Dr. Lukowski. “These data suggest that mental health issues alone are not a barrier to successfully quitting, but outcomes appear to be driven by how smokers feel that their mental health issues will or will not influence their ability to quit tobacco.”

As part of its focus on respiratory health, National Jewish Health has been a quitline service provider since December 2002, and has served more than one million participants across 15 states, several corporations and numerous health plans. National Jewish Health QuitLogix is an evidence-based cessation program that includes telephonic counseling, an integrated website, email, text messaging and a mobile app. The intensive one-on-one program offers quit plans customized for each participant. Many of the state and other quitlines operated by National Jewish Health also offer nicotine-replacement therapy as part of the program. Information and coaching are available in English and Spanish.

Only 3 to 5 percent of people trying to quit tobacco on their own are successful. Approximately 35 percent of people using the National Jewish Health QuitLogix program quit and remain tobacco free six months later.