Miriam K Forbes1, Julianne C Flanagan2, Emma L Barrett3, Erica Crome4, Andrew J Baillie5, Katherine L Mills6, Maree Teesson7. 1. Centre for Emotional Health and Centre of Research Excellence in Mental Health and Substance Abuse, Macquarie University, Sydney, NSW 2109, Australia. Electronic address: miri.forbes@mq.edu.au. 2. Medical University of South Carolina, 5 Charleston Center Drive, Suite 151, Charleston, SC 29401, United States. Electronic address: hellmuth@musc.edu. 3. Centre of Research Excellence in Mental Health and Substance Abuse and National Drug and Alcohol Research Centre, UNSW, Sydney, NSW 2052, Australia. Electronic address: e.barrett@unsw.edu.au. 4. Centre for Emotional Health and Centre of Research Excellence in Mental Health and Substance Abuse, Macquarie University, Sydney, NSW 2109, Australia. Electronic address: erica.crome@mq.edu.au. 5. Centre for Emotional Health and Centre of Research Excellence in Mental Health and Substance Abuse, Macquarie University, Sydney, NSW 2109, Australia. Electronic address: andrew.baillie@mq.edu.au. 6. Centre of Research Excellence in Mental Health and Substance Abuse and National Drug and Alcohol Research Centre, UNSW, Sydney, NSW 2052, Australia. Electronic address: k.mills@unsw.edu.au. 7. Centre of Research Excellence in Mental Health and Substance Abuse and National Drug and Alcohol Research Centre, UNSW, Sydney, NSW 2052, Australia. Electronic address: m.teesson@unsw.edu.au.
Abstract
BACKGROUND: Posttraumatic stress disorder (PTSD) and alcohol use disorders (AUDs) often co-occur with smoking and tobacco use disorders. Each of these disorders is known to have negative health consequences and impairment independently, but little is known about the impact of their co-occurrence. The aim of the present study is to examine the prevalence, correlates, order of onset, and impact of co-occurring daily smoking, PTSD, and AUDs. METHOD: The 2007 Australian National Survey of Mental Health and Wellbeing (2007 NSMHWB) was a nationally representative survey of 8841 Australians. The survey assessed for 12-month DSM-IV mental disorders; the age respondents first started smoking daily, experienced a traumatic event, or developed problems with alcohol; and self-reported mental and physical health and impairment. RESULTS: There were systematic patterns of co-occurrence between daily smoking, PTSD, and AUDs. Daily smoking and problems with alcohol use tended to develop after first trauma exposure, which is broadly consistent with the self-medication hypothesis. Daily smoking, PTSD, and AUDs were also associated with additive negative effects on mental and physical health and functioning, after controlling for demographics. CONCLUSIONS: Smoking, PTSD, and AUDs commonly co-occur in this nationally representative sample of Australian men and women, and this comorbidity was associated with greater severity of mental and physical health problems and impairment in several areas of functioning. This study highlights the importance of identifying and eliminating these patterns of co-occurrence, potentially through integrated interventions.
BACKGROUND:Posttraumatic stress disorder (PTSD) and alcohol use disorders (AUDs) often co-occur with smoking and tobacco use disorders. Each of these disorders is known to have negative health consequences and impairment independently, but little is known about the impact of their co-occurrence. The aim of the present study is to examine the prevalence, correlates, order of onset, and impact of co-occurring daily smoking, PTSD, and AUDs. METHOD: The 2007 Australian National Survey of Mental Health and Wellbeing (2007 NSMHWB) was a nationally representative survey of 8841 Australians. The survey assessed for 12-month DSM-IV mental disorders; the age respondents first started smoking daily, experienced a traumatic event, or developed problems with alcohol; and self-reported mental and physical health and impairment. RESULTS: There were systematic patterns of co-occurrence between daily smoking, PTSD, and AUDs. Daily smoking and problems with alcohol use tended to develop after first trauma exposure, which is broadly consistent with the self-medication hypothesis. Daily smoking, PTSD, and AUDs were also associated with additive negative effects on mental and physical health and functioning, after controlling for demographics. CONCLUSIONS: Smoking, PTSD, and AUDs commonly co-occur in this nationally representative sample of Australian men and women, and this comorbidity was associated with greater severity of mental and physical health problems and impairment in several areas of functioning. This study highlights the importance of identifying and eliminating these patterns of co-occurrence, potentially through integrated interventions.
Authors: Maree Teesson; Wayne Hall; Tim Slade; Katherine Mills; Rachel Grove; Louise Mewton; Andrew Baillie; Paul Haber Journal: Addiction Date: 2010-08-12 Impact factor: 6.526