Mental health and readiness to change smoking behavior in daily smoking primary care patients

Purpose: We examined the association between daily smokers' mental health according to the five-item Mental Health Inventory and the core constructs of the transtheoretical model (TTM): stage of change, processes of change, smoking cessation self-efficacy, and decisional balance. Method: Questionnaire data from 1,334 daily smoking primary care patients were used for multinomial logistic, linear, and ordinal logistic regression analyses controlling for effects of sociodemographic characteristics. Results: Smokers with lower levels of mental health had increased odds to contemplate quitting within the next 6 months compared to not intending to quit at all. In addition, they reported an elevated use of change processes as well as an enhanced endorsement of positive and negative aspects of nonsmoking. However, in a subsample analysis performed on smokers in contemplation stage, low mental health was related to lower self-efficacy expectancies in negative affect situations. Conclusion: Mental health does not appear to constitute a precondition for readiness to change smoking behavior in daily smokers. Nonetheless, smokers with low mental health might require support to deal with negative affect situations.