Psychological distress affects tobacco use differently for men and women

A new study in the American Journal of Health Behavior finds that women are more likely than men to use tobacco products after experiencing severe psychological distress.

The researchers, led by Mary Hrywna, MPH, of the Center for Tobacco Studies at Rutgers School of Public Health, noted that it's a well established finding that individuals with mental illnesses use tobacco more than others. Research indicates that mentally ill people "consume an estimated 44.3 percent of the cigarettes" in the U.S., and that disorders like depression, anxiety and psychological distress affect more women than men.

Previous research has found that it's harder for women to quit smoking than it is for men. Yet little prior public health research has examined how gender affects the relationship between mental health and tobacco use, including products other than cigarettes.

The researchers used data from 26,907 adult participants in the 2010 National Health Interview Survey (NHIS), which included questions about tobacco use of all types. Participants also answered questions about whether they had experienced psychological distress in the prior 30 days, rating their feelings of hopelessness, worthlessness, anxiety, etc.

"Overall, 3.3 percent of adult participants in the U.S. were found to have severe psychological distress in the preceding month," the authors wrote. Lifetime and current use of tobacco was greater among adults reporting severe psychological distress than those without it.

Notably, women experiencing severe psychological distress had greater odds of using cigars and smokeless tobacco than women without distress. Generally, the authors observed, the use of cigars and smokeless tobacco are "behaviors of males" and they found low use of such products among women without severe psychological distress. The researchers added that planners of cessation programs may want to tailor interventions for women and also assess a smoker's mental health when providing treatment.

"This is one of the very few published articles to examine psychological distress and tobacco use along gender lines," said Richard Brunswick, M.D., MPH, a smoking-cessation expert and author. Brunswick called the finding that women are much more likely than men to use cigars and smokeless tobacco products but not cigarettes if they feel markedly anxious or depressed "noteworthy," especially in light of increased marketing of these products to women.