{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T18:07:18Z","timestamp":1787681238057,"version":"build-2784847793"},"reference-count":49,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2022,11,16]],"date-time":"2022-11-16T00:00:00Z","timestamp":1668556800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100019346","name":"Instituto Nacional de Cancerolog\u00eda","doi-asserted-by":"publisher","award":["R01CA229355\u201003"],"award-info":[{"award-number":["R01CA229355\u201003"]}],"id":[{"id":"10.13039\/100019346","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Addiction"],"published-print":{"date-parts":[[2023,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aims<\/jats:title><jats:p>To estimate recent trends in cigarette use and health insurance coverage for United States adults with and without mental health and substance use disorders (MH\/SUD).<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>Event study analysis of smoking and insurance coverage trends among US adults with and without MH\/SUD using 2008\u201319 public use data from the National Survey on Drug Use and Health, an annual, cross\u2010sectional survey.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>USA.<\/jats:p><\/jats:sec><jats:sec><jats:title>Participants<\/jats:title><jats:p>A nationally representative sample of non\u2010institutionalized respondents aged 18\u201364\u2009years (<jats:italic>n<\/jats:italic>\u2009=\u2009448\u00a0762).<\/jats:p><\/jats:sec><jats:sec><jats:title>Measurements<\/jats:title><jats:p>Outcome variables were three measures of recent cigarette use and one measure of past\u2010year health insurance coverage. We compared outcomes between people with and without MH\/SUD (MH disorder: past\u2010year mental illness, predicted from Kessler\u20106 and the World Health Organization\u2013Disability Assessment Schedule impairment scale; SUD: met survey\u2010based DSM\u2010IV criteria for past\u2010year alcohol, cannabis, cocaine or heroin use disorder) and over time.<\/jats:p><\/jats:sec><jats:sec><jats:title>Findings<\/jats:title><jats:p>Comparing pooled data from 2008 to 2009 and from 2018 to 2019, current smoking rates of adults with MH\/SUD decreased from 37.9 to 27.9% while current smoking rates of adults without MH\/SUD decreased from 21.4 to 16.3%, a significant difference in decrease of 4.9 percentage points (pts)\u00a0[95% confidence interval (CI)\u2009=\u20093.3\u20136.6 pts]. Daily smoking followed similar patterns (difference in decrease of 3.9 pts (95% CI\u2009=\u20092.3\u20135.4 pts). Recent smoking abstinence rates for adults with MH\/SUD increased from 7.4 to 10.9%, while recent smoking abstinence rates for adults without MH\/SUD increased from 9.6 to 12.0%, a difference in increase of 1.0 pts (95% CI\u2009=\u2009\u22123.0 to 0.9 pts). In 2018\u201319, 11% of net reductions in current smoking, 12% of net reductions in daily smoking and 12% of net increases in recent smoking abstinence coincided with greater gains in insurance coverage for adults with MH\/SUD compared to those without MH\/SUD.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Improvements in smoking and abstinence outcomes for US adults with mental health and substance use disorders appear to be associated with increases in health insurance coverage.<\/jats:p><\/jats:sec>","DOI":"10.1111\/add.16052","type":"journal-article","created":{"date-parts":[[2022,11,17]],"date-time":"2022-11-17T05:07:35Z","timestamp":1668661655000},"page":"353-364","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Trends in cigarette use and health insurance coverage among US adults with mental health and substance use 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