Is There Evidence of ‘Hardening’ Among Australian Smokers Between 1997 and 2007? Analyses of the Australian National Surveys of Mental Health and Well-Being

Abstract

Objectives: To use data from the 1997 and 2007 National Surveys of Mental Health and Well-Being (NSMHWB) to assess whether Australian smokers in 2007 have higher rates of mental distress and social disadvantage than smokers in 1997. Method: We compared symptoms of mental distress and social disadvantage in Australian smokers in the 1997 and 2007 National Surveys of Mental Health and Well-Being (N = 10 373 in 1997 and N = 8135 in 2007). Both surveys used multistage probability samples of Australians living in private dwellings. Participants were classified into smokers and non-smokers (which included former and never smokers). We used the Kessler 10 (K10) symptom score to classify smokers into three levels of psychological distress (low, medium or high) and socioeconomic disadvantage was measured using an area-based index of relative disadvantage converted into quintiles. We used logistic regressions to: (i) examine associations between smoking status (smoker/non-smoker) and psychological distress and socioeconomic disadvantage in 1997 and 2007 surveys; and (ii) to test whether the prevalence of psychological distress and social disadvantage among smokers increased between 1997 and 2007. Results: Psychological distress and social disadvantage were more common among smokers than non-smokers in both surveys but there was no evidence that the prevalence of psychological distress or social disadvantage was more common among smokers in 2007 than in 1997. Conclusion: We find no evidence that the declining smoking prevalence in Australia (over the last decade) has been accompanied by a ‘hardening’ of continuing smokers in terms of rates of mental disorders and socioeconomic disadvantage.