Craig N Sawchuk1, Peter Roy-Byrne2, Carolyn Noonan3, Andy Bogart4, Jack Goldberg5, Spero M Manson6, Dedra Buchwald3. 1. Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN; sawchuk.craig@mayo.edu. 2. Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA; 3. Department of Medicine, University of Washington, Seattle, WA; 4. Group Health Cooperative, Center for Health Studies, Seattle, WA; 5. Department of Epidemiology, University of Washington, Seattle, WA; 6. American Indian and Alaska Native Programs, University of Colorado Health Sciences Center, Aurora, CO.
Abstract
INTRODUCTION: Rates of cigarette smoking are disproportionately high among American Indian populations, although regional differences exist in smoking prevalence. Previous research has noted that anxiety and depression are associated with higher rates of cigarette use. We asked whether lifetime panic disorder, posttraumatic stress disorder, and major depression were related to lifetime cigarette smoking in two geographically distinct American Indian tribes. METHODS: Data were collected in 1997-1999 from 1506 Northern Plains and 1268 Southwest tribal members; data were analyzed in 2009. Regression analyses examined the association between lifetime anxiety and depressive disorders and odds of lifetime smoking status after controlling for sociodemographic variables and alcohol use disorders. Institutional and tribal approvals were obtained for all study procedures, and all participants provided informed consent. RESULTS: Odds of smoking were two times higher in Southwest participants with panic disorder and major depression, and 1.7 times higher in those with posttraumatic stress disorder, after controlling for sociodemographic variables. After accounting for alcohol use disorders, only major depression remained significantly associated with smoking. In the Northern Plains, psychiatric disorders were not associated with smoking. Increasing psychiatric comorbidity was significantly linked to increased smoking odds in both tribes, especially in the Southwest. CONCLUSIONS: This study is the first to examine the association between psychiatric conditions and lifetime smoking in two large, geographically diverse community samples of American Indians. While the direction of the relationship between nicotine use and psychiatric disorders cannot be determined, understanding unique social, environmental, and cultural differences that contribute to the tobacco-psychiatric disorder relationship may help guide tribe-specific commercial tobacco control strategies.
INTRODUCTION: Rates of cigarette smoking are disproportionately high among American Indian populations, although regional differences exist in smoking prevalence. Previous research has noted that anxiety and depression are associated with higher rates of cigarette use. We asked whether lifetime panic disorder, posttraumatic stress disorder, and major depression were related to lifetime cigarette smoking in two geographically distinct American Indian tribes. METHODS: Data were collected in 1997-1999 from 1506 Northern Plains and 1268 Southwest tribal members; data were analyzed in 2009. Regression analyses examined the association between lifetime anxiety and depressive disorders and odds of lifetime smoking status after controlling for sociodemographic variables and alcohol use disorders. Institutional and tribal approvals were obtained for all study procedures, and all participants provided informed consent. RESULTS: Odds of smoking were two times higher in Southwest participants with panic disorder and major depression, and 1.7 times higher in those with posttraumatic stress disorder, after controlling for sociodemographic variables. After accounting for alcohol use disorders, only major depression remained significantly associated with smoking. In the Northern Plains, psychiatric disorders were not associated with smoking. Increasing psychiatric comorbidity was significantly linked to increased smoking odds in both tribes, especially in the Southwest. CONCLUSIONS: This study is the first to examine the association between psychiatric conditions and lifetime smoking in two large, geographically diverse community samples of American Indians. While the direction of the relationship between nicotine use and psychiatric disorders cannot be determined, understanding unique social, environmental, and cultural differences that contribute to the tobacco-psychiatric disorder relationship may help guide tribe-specific commercial tobacco control strategies.
Authors: Janette Beals; Spero M Manson; Nancy R Whitesell; Paul Spicer; Douglas K Novins; Christina M Mitchell Journal: Arch Gen Psychiatry Date: 2005-01
Authors: Craig N Sawchuk; Peter Roy-Byrne; Carolyn Noonan; Andy Bogart; Jack Goldberg; Spero M Manson; Dedra Buchwald Journal: Nicotine Tob Res Date: 2012-02-17 Impact factor: 4.244
Authors: Craig N Sawchuk; Peter Roy-Byrne; Carolyn Noonan; Julia R Craner; Jack Goldberg; Spero Manson; Dedra Buchwald Journal: J Anxiety Disord Date: 2016-10-05
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Authors: Dorothy A Rhoades; Ashley L Comiford; Justin D Dvorak; Kai Ding; Leslie M Driskill; Audrea M Hopkins; Paul Spicer; Theodore L Wagener; Mark P Doescher Journal: Am J Prev Med Date: 2019-08-01 Impact factor: 5.043