{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,28]],"date-time":"2025-10-28T15:20:43Z","timestamp":1761664843802,"version":"build-2065373602"},"reference-count":25,"publisher":"BMJ","issue":"6","license":[{"start":{"date-parts":[[2025,6,16]],"date-time":"2025-06-16T00:00:00Z","timestamp":1750032000000},"content-version":"unspecified","delay-in-days":15,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2025,6,9]]},"published-print":{"date-parts":[[2025,6]]},"abstract":"<jats:sec>\n                  <jats:title>Objective<\/jats:title>\n                  <jats:p>Alcohol consumption and tobacco smoking have the potential to increase psychological distress. We evaluated the effect of alcohol consumption and tobacco smoking on psychological distress among adults in Kenya using a quasi-experimental study.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Design<\/jats:title>\n                  <jats:p>Quasi-experimental study.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Setting<\/jats:title>\n                  <jats:p>Kenya.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Participants<\/jats:title>\n                  <jats:p>Adults aged 15\u201354 years.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>We analysed the 2022 Kenya Demographic Health Survey data. The primary exposure was alcohol consumption, and tobacco smoking was the secondary exposure. The outcome was psychological distress. We employed propensity score matching to achieve comparability on observed covariates between the exposed and unexposed groups. We then performed conditional logistic regression analysis, adjusting for matched pairs to establish a cause-effect relation between the exposures of interest and the outcome. We reported the OR and 95% CI. We conducted a sensitivity analysis using Mantel\u2013Haenszel bounds to check for the robustness of the cause-effect findings to unmeasured confounders.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Of the 46 609 participants included in the study, 6450 (13.8%) consumed alcohol, while 2353 (5.0%) smoked tobacco. Overall, 1091 (2.3%) participants reported psychological distress. Among alcohol consumers, 352 (32.3%) reported psychological distress, compared with 115 (10.5%) among tobacco smokers. In a 1:1 ratio, we matched 10\u2009070 individuals based on alcohol consumption and 4270 based on tobacco smoking status. In propensity-score-matched analysis, alcohol consumption (OR 2.76, 95%\u2009CI 2.06 to 3.70) and tobacco smoking (OR 2.04, 95% CI 1.29 to 3.24) showed an effect on psychological distress.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>This study found that alcohol consumption and tobacco smoking increase psychological distress among adults aged 15\u201354 years in Kenya. There is, therefore, a need to screen for psychological distress among people who drink alcohol or smoke tobacco to provide them with prompt mental health interventions.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/bmjopen-2025-103659","type":"journal-article","created":{"date-parts":[[2025,6,17]],"date-time":"2025-06-17T06:20:32Z","timestamp":1750141232000},"page":"e103659","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Effect of alcohol consumption and tobacco smoking on psychological distress: a quasi-experimental study using the 2022 Kenya demographic health survey data"],"prefix":"10.1136","volume":"15","author":[{"given":"Kennedy","family":"Kamau","sequence":"first","affiliation":[{"name":"African Population and Health Research Center, Nairobi, Kenya"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pauline","family":"Andeso","sequence":"additional","affiliation":[{"name":"African Population and Health Research Center, Nairobi, Kenya"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Winstoun","family":"Muga","sequence":"additional","affiliation":[{"name":"African Population and Health Research Center, Nairobi, Kenya"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amani","family":"Karisa","sequence":"additional","affiliation":[{"name":"African Population and Health Research Center, Nairobi, Kenya"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Davis","family":"Musyoki","sequence":"additional","affiliation":[{"name":"African Population and Health Research Center, Nairobi, Kenya"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joseph Mutura","family":"Kuria","sequence":"additional","affiliation":[{"name":"African Population and Health Research Center, Nairobi, Kenya"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7586-4928","authenticated-orcid":false,"given":"Damazo T","family":"Kadengye","sequence":"additional","affiliation":[{"name":"African Population and Health Research Center, Nairobi, Kenya"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9065-0389","authenticated-orcid":false,"given":"Jonathan","family":"Izudi","sequence":"additional","affiliation":[{"name":"Community Health, Mbarara University of Science and Technology, Mbarara, Uganda"},{"name":"Directorate of Graduate Training, Research and Innovation, Muni University, Arua, Uganda"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2025,6,17]]},"reference":[{"key":"2025101810231308000_15.6.e103659.1","doi-asserted-by":"crossref","DOI":"10.1186\/s12889-021-10560-y","article-title":"Factors contributing to psychological distress in the working population, with a special reference to gender difference","volume":"21","author":"Vierti\u00f6","year":"2021","journal-title":"BMC Public Health"},{"key":"2025101810231308000_15.6.e103659.2","doi-asserted-by":"publisher","DOI":"10.1016\/j.psychres.2008.05.012"},{"key":"2025101810231308000_15.6.e103659.3","first-page":"1247","article-title":"Prevalence and Associated Factors of Psychological Distress among Nurses in Public Hospitals, Southwest, Ethiopia: A cross-sectional Study","volume":"31","author":"Belay","year":"2021","journal-title":"Ethiop J Health Sci"},{"key":"2025101810231308000_15.6.e103659.4","unstructured":"WHO . 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