· MMWR. Morbidity and mortality weekly report 2013 · Repeated cross-sectional survey · n=?

Vital signs: current cigarette smoking among adults aged ≥18 years with mental illness - United States, 2009-2011.

Cited 182 times in the scientific literature.

Level 4 - case-series / case-control

Cross-sectional national survey analysis (NSDUH 2009–2011)

PubMed 23388551 · record verified 2026-08-31

What was done

Combined data from the 2009–2011 National Survey on Drug Use and Health (NSDUH) were analyzed to determine national and state-level cigarette smoking prevalence among US adults aged ≥18 years with any mental illness (AMI). AMI was defined as having a mental, behavioral, or emotional disorder in the past 12 months, excluding developmental and substance use disorders.

What was found

An annual average of 19.9% of US adults had AMI during 2009–2011. Current cigarette smoking prevalence was 36.1% among adults with AMI compared with 21.4% among adults without mental illness. Adults with AMI consumed 30.9% of all cigarettes smoked by adults. Within the AMI population, smoking prevalence was highest among men, individuals aged <45 years, and those living below the poverty level, while lowest among college graduates. Regional smoking prevalence among adults with AMI was lowest in the West (31.5%) and Northeast (34.7%) and highest in the Midwest (39.1%) and South (37.8%), ranging by state from 18.2% (Utah) to 48.7% (West Virginia).

Why it matters

These findings establish that adults with mental illness account for nearly one-third of all cigarettes consumed in the United States, highlighting a major public health disparity and the need to integrate evidence-based tobacco cessation into mental health care.

Limits

The abstract does not state the total participant sample size (n). The data rely on cross-sectional self-reports without biochemical verification of smoking, exclude substance use and developmental disorders from the AMI definition, and cannot evaluate longitudinal causality.

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