# Cigarette Smoking as a Risk Factor for Greater Psychiatric Symptom Severity across Serious Mental Illnesses: A Secondary Analysis of Three Nationally-Representative NIH Datasets

> **NIH NIH R21** · UNIVERSITY OF MINNESOTA · 2021 · $193,750

## Abstract

PROJECT ABSTRACT
Over the past 50 years, the US smoking rate was reduced by two-thirds from 42% in the 1960s to 14%
currently. Smoking prevention campaigns, such as those led by the Center for Tobacco Products, include
multimedia educational programs and health warning labels on cigarette packaging, which are highly effective
and played a key role in this reduction. However, smoking rates remain high in certain vulnerable
subpopulations (e.g. youth, minorities, LGBTQ people) and the CTP is now targeting smoking prevention
campaigns to these subpopulations. One vulnerable subpopulation that has not yet been targeted is
people with serious mental illnesses (SMIs) such as bipolar disorder (BD), schizophrenia (SCZ), and
major depressive disorder (MDD). SMIs affect more than 1 in 5 Americans and people with SMIs are twice
as likely to smoke as people without SMIs. Accordingly 40% of all cigarettes are smoked by people with
SMIs. Education campaigns have long been used to reach people with SMIs and have been successful in
increasing treatment rates and reducing suicidal behavior. In light of their success, the lack of a smoking
prevention campaign targeted to the SMI subpopulation is striking. The first step in designing a successful
campaign is establishing the scientific foundation for messaging that will resonate with the SMI
subpopulation. Focusing on the mental health consequences of smoking is a logical choice. People with SMIs
typically spend 15%-25% of their lives symptomatic, and symptoms are distressing, cause role impairment,
and when severe require hospitalization. We will conduct the most rigorous investigation yet done on whether
smoking is a risk factor for greater psychiatric symptom severity in people with SMIs, using three specific aims:
SA1: Determine whether smoking is a risk factor for increased time in illness episodes in people with
SMIs. We hypothesize that BD smokers will spend more time in mood episodes (depression+mania) than BD
non-smokers, SCZ smokers will spend more time in psychotic episodes, and MDD smokers will spend more
time in depressive episodes. SA2: Determine whether smoking is a risk factor for increased time in
depression across SMIs. Depression is the psychiatric syndrome most commonly attributed to smoking, and
people with BD, SCZ, and MDD are all vulnerable to depression. An alternate hypothesis to SA1 is that
smoking has a specific depressogenic effect and that across all three SMIs smokers will spend more time in
depressive episodes than non-smokers. SA3: Determine predictors of within-person changes in smoking
behavior (initiating, quitting, relapsing). We hypothesize that smokers with lower psychiatric symptom
severity will be more likely to quit smoking, while quitters who experience a subsequent increase in symptoms
will be more likely to relapse into smoking. The proposed project will advance tobacco regulatory science and
protect public health by establishing the scientific foundation for a smoking pr...

## Key facts

- **NIH application ID:** 10220010
- **Project number:** 5R21DA051538-02
- **Recipient organization:** UNIVERSITY OF MINNESOTA
- **Principal Investigator:** David J Bond
- **Activity code:** R21 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $193,750
- **Award type:** 5
- **Project period:** 2020-08-01 → 2022-12-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10220010

## Citation

> US National Institutes of Health, RePORTER application 10220010, Cigarette Smoking as a Risk Factor for Greater Psychiatric Symptom Severity across Serious Mental Illnesses: A Secondary Analysis of Three Nationally-Representative NIH Datasets (5R21DA051538-02). Retrieved via AI Analytics 2026-05-25 from https://api.ai-analytics.org/grant/nih/10220010. Licensed CC0.

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