Motivations for smoking in young adults with mental health disorders

Smoking prevalence is significantly higher in young adults with mental health disorders (MHD) than in those without. Smoking may be a factor in causing MHD or those with MHD may be more likely to smoke, e.g., as a form of self-medication. There is evidence of a causal effect of smoking on young adult depression, but mechanisms remain unclear. We compare motivations for smoking in young adults with and without MHD. We use data from 5,190, 20 year-olds from Wave 4 of Growing Up in Ireland Child Cohort who reported MHD, diagnosed by a clinician and who reported ever- and current smoking status, and motivations for smoking “What would you say is your MOST IMPORTANT reason for smoking? [7 options]. Analyses were performed using SPSS v27. Young adults with MHD represented 19.4% of the sample and were significantly more likely (p< 0.01) to report ever-smoking (78.4%, n=789 vs 72.8%, n=3016) and current smoking (47%, n=474 vs 35.2%, n=1472) than those without MHD. Overall, most reported reasons for smoking were, because friends smoke (29.7%, n=1082), they enjoy it (20.9%, n=762) and it helps to cope with stress (15%, n=547). Statistically significant differences in motivations between those with and without MHD include those with MHD being twice as likely to say that smoking helps to cope with stress (25%, n=178 vs 12.6%, n=369) and that they are unable to quit (3.5%, n=25 vs 1.7%, n=49). They were less likely to report peer influence on their smoking (21.3%, n=152 vs 31.7%, n=930). Differences in motivations for smoking between young adults with and without MHD may help explain the increased smoking prevalence in MHD and may be useful in tailoring smoking prevention and cessation services for this vulnerable population.