Pathways to health in a deprived population: relationships between smoking, mental health & physical health

Abstract

Introduction: Recently there has been increasing interest in understanding and addressing health inequalities and enhancing the well-being of the population as a whole through anticipatory care and better health care delivery. The current study aimed to investigate the predictive relationships between smoking behaviour, physical health, and mental health in a deprived population using models of mediation. Method: Participants had attended a Keep Well health check, a national programme offering health screening, advice, referrals and signposting to individuals aged 45-64 living in deprived areas. Participants completed a questionnaire measuring smoking status, physical health (RAND general health subscale), mental health symptoms (GHQ-12), positive mental health (WEMWBS), and demographic information. Results: The current study found that smoking mediated the relationship between mental health problems and physical health, as well as mediating the relationship between positive mental health and physical health. Discussion: These findings suggest that by offering interventions to encourage individuals to stop smoking health care providers can hope to reduce mental health problems via direct effects but also via an indirect benefit of improvements in physical health. There are also opportunities to improve physical health via the direct effects of reducing mental health problems and increasing positive mental health, as well as the indirect effect of smoking.