, 2004; Lasser et al., 2000; Saffer & Dave, 2005; Ziedonis & Williams, 2003). This discrepancy is due to differences in mental illness measurement. The previous studies estimated that persons with mental illness comprised over 24% of U.S. adults based on a wide range of mental disorder diagnoses, selleck inhibitor including alcohol/drug abuse or dependence and phobias (Grant et al., 2004; Saffer & Dave, 2005). In this study, 8.6% of adults were screened positive for SPD based on the K6 scale, which is a nonspecific psychological distress measure not based on diagnoses or impairment but has great precision in identifying ��serious mental illness�� in the past twelve months, estimated to afflict about 6% of U.S. adults (Kessler et al., 1996, 2001). Given that the K6 scale has low sensitivity but high specificity for serious mental illness (Kessler et al.
, 2003), persons identified with SPD would appear to be a subset of those with serious mental illness. On the other hand, our results indicate a greater degree of smoking disparity among persons with SPD in terms of two measures. The first, the ratio of the proportion of all cigarettes smoked by persons with SPD and the prevalence of SPD, was 2.2 (=19.2/8.6) in our study compared with 1.6 (=44.4/28.3) in the study by Lasser et al. (2000). The second, the ratio of the proportion of current smokers with SPD and the prevalence of SPD, was 2.0 (=16.8/8.6) in our study compared with 1.4 (=40.6/28.3) in the study by Lasser et al. (2000). The difference is likely due to a greater degree of mental illness severity captured by the K6 scale.
This study contributes to the literature by including two mutually exclusive levels of SPD acuity����acute SPD�� in the past thirty days and ��recent SPD�� in the past two to twelve months. We observed that current smoking prevalence increased from 13.1% for persons without SPD to 27.2% for those with recent SPD and to 30.1% for those with acute SPD. This study also extends existing research by examining the proportion of heavy smokers conditional on current smoking. We found that persons with acute SPD not only were more likely to be current smokers but also tended to be heavy smokers once they smoked. Heavier smoking suggests higher nicotine dependence (Diaz et al., 2005). Therefore, this result suggests that persons with SPD in the most recent 30 days should be particularly aided by their clinicians and other professional providers with smoking prevention and cessation efforts (Schroeder, 2009). Individuals with SPD also were less likely to quit smoking after starting. The findings highlight the need for health policy interventions to limit the exposure to tobacco use among Anacetrapib those with SPD.