Kevin P Conway1, Victoria R Green2, Karin A Kasza3, Marushka L Silveira2, Nicolette Borek4, Heather L Kimmel5, James D Sargent6, Cassandra Stanton7, Elizabeth Lambert5, Nahla Hilmi2, Chad J Reissig4, Kia J Jackson4, Susanne E Tanski6, David Maklan7, Andrew J Hyland3, Wilson M Compton5. 1. Division of Epidemiology, Services, Prevention Research, National Institute on Drug Abuse, National Institutes of Health, Bethesda, MD, United States. Electronic address: kconway@nida.nih.gov. 2. Division of Epidemiology, Services, Prevention Research, National Institute on Drug Abuse, National Institutes of Health, Bethesda, MD, United States; Kelly Government Solutions, Rockville, MD, United States. 3. Department of Health Behavior, Roswell Park Cancer Institute, Buffalo, NY, United States. 4. Office of Science, Center for Tobacco Products, Food and Drug Administration, Silver Spring, MD, United States. 5. Division of Epidemiology, Services, Prevention Research, National Institute on Drug Abuse, National Institutes of Health, Bethesda, MD, United States. 6. C. Everett Koop Institute, Norris Cotton Cancer Center, Geisel School of Medicine at Dartmouth, United States. 7. Westat, Rockville, MD, United States.
Abstract
BACKGROUND: Although non-cigarette tobacco product use is increasing among U.S. adults, their associations with substance use and mental health problems are unclear. This study examined co-occurrence of tobacco use, substance use, and mental health problems, and its moderation by gender, among 32,202U.S. adults from Wave 1 (2013-2014) of the nationally representative longitudinal Population Assessment of Tobacco and Health (PATH) Study. METHODS: Participants self-reported current cigarette, e-cigarette, traditional cigar, cigarillo, filtered cigar, hookah, smokeless tobacco and other tobacco product use; past year alcohol, marijuana, and other drug use; and past year substance use, internalizing and externalizing problems. RESULTS: Compared to non-current tobacco users, current users were more likely to report alcohol or drug use (adjusted odds ratio (AOR)=2.6; 95% confidence interval (CI): 2.3, 2.9), with the strongest associations observed for cigarillo and hookah users. Across all tobacco product groups, users were more likely to report internalizing (AOR=1.9; 95% CI: 1.7, 2.1), externalizing (AOR=1.6; 95% CI: 1.5, 1.8), and substance use (AOR=3.4; 95% CI: 2.9, 4.1) problems than non-users. Gender moderated many of these associations and, of these, all non-cigarette tobacco product associations were stronger among females. CONCLUSIONS: This nationally representative study of U.S. adults is the first to comprehensively document tobacco use, substance use, and mental health comorbidities across the range of currently available tobacco products, while also demonstrating that female tobacco users are at increased risk for substance use and mental health problems. These findings may point to gender differences in vulnerability and suggest that interventions incorporate gender-specific approaches.
BACKGROUND: Although non-cigarette tobacco product use is increasing among U.S. adults, their associations with substance use and mental health problems are unclear. This study examined co-occurrence of tobacco use, substance use, and mental health problems, and its moderation by gender, among 32,202U.S. adults from Wave 1 (2013-2014) of the nationally representative longitudinal Population Assessment of Tobacco and Health (PATH) Study. METHODS:Participants self-reported current cigarette, e-cigarette, traditional cigar, cigarillo, filtered cigar, hookah, smokeless tobacco and other tobacco product use; past year alcohol, marijuana, and other drug use; and past year substance use, internalizing and externalizing problems. RESULTS: Compared to non-current tobacco users, current users were more likely to report alcohol or drug use (adjusted odds ratio (AOR)=2.6; 95% confidence interval (CI): 2.3, 2.9), with the strongest associations observed for cigarillo and hookah users. Across all tobacco product groups, users were more likely to report internalizing (AOR=1.9; 95% CI: 1.7, 2.1), externalizing (AOR=1.6; 95% CI: 1.5, 1.8), and substance use (AOR=3.4; 95% CI: 2.9, 4.1) problems than non-users. Gender moderated many of these associations and, of these, all non-cigarette tobacco product associations were stronger among females. CONCLUSIONS: This nationally representative study of U.S. adults is the first to comprehensively document tobacco use, substance use, and mental health comorbidities across the range of currently available tobacco products, while also demonstrating that female tobacco users are at increased risk for substance use and mental health problems. These findings may point to gender differences in vulnerability and suggest that interventions incorporate gender-specific approaches.
Authors: Israel T Agaku; Brian A King; Corinne G Husten; Rebecca Bunnell; Bridget K Ambrose; S Sean Hu; Enver Holder-Hayes; Hannah R Day Journal: MMWR Morb Mortal Wkly Rep Date: 2014-06-27 Impact factor: 17.586
Authors: Kevin P Conway; Victoria R Green; Karin A Kasza; Marushka L Silveira; Nicolette Borek; Heather L Kimmel; James D Sargent; Cassandra A Stanton; Elizabeth Lambert; Nahla Hilmi; Chad J Reissig; Kia J Jackson; Susanne E Tanski; David Maklan; Andrew J Hyland; Wilson M Compton Journal: Addict Behav Date: 2017-08-18 Impact factor: 3.913
Authors: Victoria R Green; Kevin P Conway; Marushka L Silveira; Karin A Kasza; Amy Cohn; K Michael Cummings; Cassandra A Stanton; Priscilla Callahan-Lyon; Wendy Slavit; James D Sargent; Nahla Hilmi; Raymond S Niaura; Chad J Reissig; Elizabeth Lambert; Izabella Zandberg; Mary F Brunette; Susanne E Tanski; Nicolette Borek; Andrew J Hyland; Wilson M Compton Journal: J Am Acad Child Adolesc Psychiatry Date: 2018-10-04 Impact factor: 8.829