Understanding gender-race/ethnicity influences on tobacco/nicotine cessation among people with severe mental illness

Despite having intentions to quit, people with severe mental illness (SMI) often struggle to abstain from tobacco/nicotine use. This study explored the interplay between gender and race/ethnicity in relation to time to abstain from tobacco/nicotine use and the factors associated with successful quitting.

A population-based sample of 3,914 individuals was drawn from the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC-III, 2012-2013). Survival modeling methods were used to examine differences in time to abstain across gender-race/ethnicity groups and explore associated factors.

Among smokers with SMI, 31.7% had abstained from tobacco/nicotine use, with significant variation across gender-race/ethnicity groups (χ² = 32.2, p < 0.001). Non-Hispanic White females had the highest cessation rate (35.3%), while non-Hispanic Black males had the lowest (22.3%). Hispanic females had the shortest duration of use (33-39 years) and the highest likelihood of abstinence (HR = 2.07, p < 0.05), compared to non-Hispanic Black males, who had the longest use duration (45-54 years). Low social support and high levels of stressful life events were significantly associated with lower cessation rates, particularly among non-Hispanic Black males.

Findings suggest that psychiatric nurses should consider personal and demographic factors when designing cessation programs for individuals with SMI.