TABLE 3.
Proportion of trends in current and daily smoking explained by insurance coverage gains, 2008–19
| Pts (95% CI) | ||||
|---|---|---|---|---|
|
|
||||
| Direct associations | Indirect associations | Total associations | Proportion mediated | |
| Current smoking | ||||
| 2010–11 | ||||
| MH/SUD | −2.54 (−4.25, −0.84) | 0.12 (−0.13, 0.36) | −2.43 (−4.16, −0.69) | −5% |
| No MH/SUD | −0.84 (−1.64, −0.03) | 0.24 (0.12, 0.36) | −0.60 (−1.42, 0.22) | −40% |
| Difference | −1.71 (−3.46, 0.05) | −0.12 (−0.40, 0.16) | −1.83 (−3.60, −0.06) | 7% |
| 2012–13 | ||||
| MH/SUD | −2.64 (−4.27, −1.01) | −0.05 (−0.30, 0.19) | −2.70 (−4.38, −1.01) | 2% |
| No MH/SUD | −1.49 (−2.35, −0.64) | 0.16 (0.03, 0.30) | −1.33 (−2.17, −0.49) | −12% |
| Difference | −1.15 (−2.81, 0.51) | −0.22 (−0.48, 0.05) | −1.37 (−3.06, 0.33) | 16% |
| 2014–15 | ||||
| MH/SUD | −4.48 (−5.90, −3.07) | −0.68 (−0.89, −0.47) | −5.16 (−6.60, −3.72) | 13% |
| No MH/SUD | −1.67 (−2.48, −0.87) | −0.36 (−0.47, −0.25) | −2.03 (−2.85, −1.20) | 18% |
| Difference | −2.81 (−4.46, −1.16) | −0.32 (−0.56, −0.08) | −3.13 (−4.81, −1.45) | 10% |
| 2016–17 | ||||
| MH/SUD | −6.76 (−8.28, −5.25) | −1.56 (−1.77, −1.36) | −8.33 (−9.88, −6.78) | 19% |
| No MH/SUD | −2.72 (−3.52, −1.91) | −0.96 (−1.07, −0.84) | −3.67 (−4.51, −2.84) | 26% |
| Difference | −4.05 (−5.72, −2.38) | −0.61 (−0.84, −0.38) | −4.66 (−6.37, −2.94) | 13% |
| 2018–19 | ||||
| MH/SUD | −8.89 (−10.24, −7.53) | −1.50 (−1.71, −1.30) | −10.39 (−11.78, −8.99) | 14% |
| No MH/SUD | −4.14 (−4.98, −3.29) | −0.89 (−1.00, −0.77) | −5.02 (−5.89, −4.16) | 18% |
| Difference | −4.75 (−6.34, −3.16) | −0.62 (−0.84, −0.40) | −5.36 (−7.01, −3.72) | 11% |
| Daily smoking | ||||
| 2010–11 | ||||
| MH/SUD | −1.68 (−3.11, −0.25) | 0.10 (−0.11, 0.31) | −1.58 (−3.04, −0.11) | −6% |
| No MH/SUD | −0.91 (−1.65, −0.18) | 0.21 (0.10, 0.31) | −0.71 (−1.44, 0.03) | −29% |
| Difference | −0.77 (−2.30, 0.76) | −0.11 (−0.35, 0.14) | −0.87 (−2.41, 0.67) | 12% |
| 2012–13 | ||||
| MH/SUD | −2.15 (−3.54, −0.76) | −0.05 (−0.26, 0.16) | −2.20 (−3.61, −0.79) | 2% |
| No MH/SUD | −1.48 (−2.33, −0.62) | 0.14 (0.02, 0.26) | −1.33 (−2.17, −0.50) | −11% |
| Difference | −0.68 (−2.33, 0.98) | −0.19 (−0.42, 0.04) | −0.86 (−2.50, 0.78) | 22% |
| 2014–15 | ||||
| MH/SUD | −4.01 (−5.21, −2.81) | −0.59 (−0.77, −0.40) | −4.60 (−5.82, −3.38) | 13% |
| No MH/SUD | −1.64 (−2.37, −0.92) | −0.31 (−0.41, −0.21) | −1.95 (−2.68, −1.22) | 16% |
| Difference | −2.37 (−3.79, −0.96) | −0.28 (−0.49, −0.07) | −2.65 (−4.08, −1.22) | 11% |
| 2016–17 | ||||
| MH/SUD | −5.68 (−7.07, −4.29) | −1.35 (−1.53, −1.18) | −7.03 (−8.45, −5.62) | 19% |
| No MH/SUD | −2.56 (−3.29, −1.83) | −0.83 (−0.93, −0.73) | −3.39 (−4.13, −2.64) | 24% |
| Difference | −3.12 (−4.69, −1.55) | −0.53 (−0.72, −0.33) | −3.65 (−5.25, −2.05) | 14% |
| 2018–19 | ||||
| MH/SUD | −7.28 (−8.62, −5.93) | −1.30 (−1.48, −1.12) | −8.57 (−9.94, −7.21) | 15% |
| No MH/SUD | −3.45 (−4.25, −2.65) | −0.77 (−0.87, −0.66) | −4.21 (−5.02, −3.40) | 18% |
| Difference | −3.83 (−5.35, −2.31) | −0.53 (−0.72, −0.34) | −4.36 (−5.91, −2.81) | 12% |
Note:2008–19 National Survey on Drug Use and Health (NSDUH) data (unweighted sample size: n = 448 762). Structural equation models adjusted for age, sex, and race/ethnicity.
MH/SUD = mental health and substance use disorders; CI = confidence interval.