Former smokers are prone replacing one addiction for another.
Between 2005 and 2016, major depression among former smokers rose to 6% from nearly 5%. They also said their use of marijuana had increased to 10.1% from 5.3% in the year prior to being interviewed, and binge drinking rose to 22.3% from 17.2% in the month prior to being interviewed, according to the study published in the American Journal of Preventive Medicine.
“Mental health and substance-use problems are associated with smoking relapse among former smokers,” the authors said. “Yet little is known about the prevalence of mental health and substance use among former smokers in the U.S.” The authors suggest it could be a prevalent problem: Former smokers have grown to outnumber the current number of U.S. smokers (14% of adults).
Depression and substance use, which are factors associated with increased risk for cigarette use relapse, appear to be increasing over time among former U.S. smokers.
Former smokers were more likely to be older than 65, never married, have some college education, and annual incomes over $75,000. Over 50% had also quit smoking for three years or more. The increasing legalization of marijuana, the decreasing perception of risk associated with use, and reduced stigma may also have contributed to the increased marijuana use, the researchers said.
“The findings represent a looming threat to the progress that has been made in reducing the prevalence of cigarette use,” lead investigator Renee Goodwin, a psychiatric epidemiologist and clinical psychologist, said of the former smokers included in the study. “More of them are now suffering from depression and engaging in problematic substance use,” she added.
The data in the study were drawn from the National Survey on Drug Use and Health, an annual, nationally representative study. More than 67,000 individuals aged 18 and over participated in the study. The authors claimed it’s the first national U.S. study to focus on the prevalence and time trends of depression, marijuana use, and problematic alcohol use among former smokers.
The study was carried out by the Institute for Implementation Science in Population Health at The City University of New York, the Department of Epidemiology at the Mailman School of Public Health, Columbia University, and the Department of Epidemiology and Biostatistics at the Graduate School of Public Health and Health Policy, The City University of New York.
Every state in the country taxes cigarettes, with the average tax on a pack of 20 cigarettes sitting at $1.81 and some taxes — like the one in New York state — reaching as high as $4.35.
A $1 tax increase on traditional cigarettes reduces cigarette use by 1.9% overall and by 3.5% for daily smokers, a separate study co-authored by researchers from Georgia State University, Temple University, and the University of Kentucky, and distributed by the National Bureau of Economic Research last month found. It also increased vaping rates by 9.7%.
Every state in the country taxes cigarettes, with the average tax on a pack of 20 cigarettes sitting at $1.81 and some taxes — like the one in New York state — reaching as high as $4.35. These are on top of the $1.01 federal cigarette tax. A pack of cigarettes in New York City now starts at $13. This supports previous research on the effectiveness of tobacco taxation in reducing smoking.
Binge drinking is also booming — among boomers. In fact, more than one in 10 Americans ages 65 and older are binge drinkers, according to a New York University study published in the Journal of the American Geriatrics Society earlier this month; binge drinking is defined as having five or more drinks during one occasion in the past month for men, and four or more for women.
The National Institute on Alcohol Abuse and Alcoholism recommends that adults over 65 consume three alcoholic drinks or fewer a day. “Older adults are especially vulnerable to the harms of alcohol use, especially binge drinking, due to physiological changes of aging and the higher likelihood of having more chronic medical disease and taking more prescribed medications,” it concluded.
(James Wellemeyer and Nicole Pesce contributed to this story.)