Frequent Mental Distress: Associations with Nicotine Use Behaviors

Frequent mental distress (FMD) is closely related to nicotine use, and its prevalence varies across population groups. Understanding patterns of nicotine use by FMD can help identify groups that are candidates for tobacco prevention and cessation interventions.

Using pooled data from annual tobacco-related surveys of adults between 2021-2024 in New York, we used Pearson's F-tests and pair-wise tests to determine differences in the prevalence of FMD in demographic groups. We assessed associations between FMD and tobacco-related behaviors, including novel product use and quitting behavior, in adjusted regression models.

Sexual and gender minority adults, young adults, and adults living with disabilities, among other groups, were at higher risk of experiencing FMD. In adjusted models, adults who experienced FMD had higher odds of any nicotine use excluding blunts (AOR=1.39; 95% CI: 1.16-1.67) and including blunts (AOR=1.48; 95% CI: 1.24-1.77), cigarette use (AOR=1.44; 95% CI: 1.12-1.85), e-cigarette use (AOR=1.28; 95% CI: 1.01-1.64), and blunt use (AOR=1.38; 95% CI: 1.06-1.79) than adults who did not experience FMD. Among adults who currently smoked cigarettes, FMD was associated with higher odds of having made a past-year quit attempt (AOR=1.55; 95% CI: 1.01-2.38).

Adults who experienced FMD had higher adjusted odds of several nicotine use outcomes and a past-year quit attempt. Controlling for demographics, adults with FMD had higher odds of any tobacco use, cigarette use, e-cigarette use, and blunt use, but not cigar, smokeless, hookah, or nicotine pouch use.