Study shows heavy-smoking college students have more mental-health problems

A study just published in the journal Nicotine & Tobacco Research revealed that students who were heavy smokers and were seeking treatment at a university counseling facility had substantially more mental health problems than those who were nonsmokers or light smokers.

“Heavy smokers are likely to present with unfavorable and clinically relevant psychological and functional differences when compared with light smokers and nonsmokers,” says Eric Heiligenstein, director of psychiatry at the University of Wisconsin–Madison Health Services and lead investigator on the study. “We believe that smoking has an undeniable impact on mental health care.”

The study compared 503 university students who sought treatment at the university clinic. These students were evaluated with a standardized and validated computer assessment tool (PsyberCare-MH, Polaris Health Directions) in three areas: subjective well-being, psychiatric symptom severity, and the impact of psychological problems on their lives (functional disability). For purposes of analyses, students were divided into two groups: those with PsyberCare-MH scores below the 50th percentile and those with scores at or above the 50th percentile. Scores below the 50th percentile indicated greater psychiatric disability and poorer functioning.

The analyses revealed that heavy student smokers (more than 10 cigarettes per day) reported substantially poorer well-being, greater depression and anxiety, and more functional disability. No differences were found between light smokers and nonsmokers.

Several factors possibly influence smoking or psychiatric morbidity among college students. These factors include the stress of transition from high school to college, preexisting psychiatric conditions that can worsen under stress, peer pressure or lack of parental influence.

“Given the relatively few years that these college students have been able to smoke, it appears that the negative effects of tobacco on mental health may occur early in a smoker’s lifetime and may not always require nicotine dependence or an extended period of tobacco use,” says Heiligenstein.

“Our findings reinforce the recommendations that smokers with psychiatric diagnoses be identified and offered tobacco cessation treatment when their mental health condition has stabilized,” says Stevens Smith, assistant professor of medicine at the UW–Madison Center for Tobacco Research and Intervention and another study author. “Future longitudinal studies are needed to determine if smoking cessation reduces the symptomatic and quality-of-life differences seen in heavier smokers.”

The demographics of the sample were typical of the university population. Mean age was just above 22 years, more than 66 percent were female and close to 87 percent were white. There were no significant differences in age, gender or ethnicity when students were compared by smoking status.

The study was published in the August 2006 issue of Nicotine & Tobacco Research.