Alcohol and tobacco use disorders in a general population: short-term and long-term associations from the St. Louis Epidemiological Catchment Area Study

Abstract

Background-Although research using clinical and convenience samples has shown alcohol use disorders (AUD) to be highly comorbid with tobacco dependence (TD), little work has examined this association prospectively using population-based data. The AUD-TD association was prospectively examined using data from the St. Louis Epidemiological Catchment Area (ECA) Study and its 1-year follow-up as well as from a 16-year follow-up on a subsample of ECA data.Method-Respondents were 3004 (2564, 85%, at Wave 2) participants in the St. Louis household ECA sample, including 444 participants at Year 16 follow-up. At baseline, the sample was predominately White (58%; 38% Black), female (60%), and 44.3 years. Past-year AUD and TD were diagnosed at all waves according to DSM-III criteria.Results-AUDs and TDs were cross-sectionally associated at Years 1, 2, and 16. Controlling for demographics, Year 1 TD prospectively predicted Year 2 AUD, and Year 1 AUD prospectively predicted Year 16 TD. We found evidence for prediction of onset and persistence of both AUD and TD at short-term but not long-term follow-up. Prospective findings were reduced and no longer reached significance when concurrent diagnoses at follow-up were included in the regression models.Conclusions-We observed short-term and long-term associations between AUD and TD. These associations were mediated through concurrent diagnoses with the other substance use disorder.

Alcohol and tobacco use patterns among heterosexually and homosexually experienced California women

“…Intervening to reduce use of one substance may have an impact on the other, though studies indicate that this is true primarily for alcohol, not smoking, interventions. Results of our study, like that of others (Jackson et al, 2003), indicate that increased risk for substance use is not necessarily drug-specific. This suggests the need for further research about stage theories in substance abuse and how this might be integral in prevention and treatment efforts of substance use/abuse among lesbians and bisexual women.…”

“…Understanding the context of lesbian and bisexual women's experiences that support the initiation and use of tobacco will be critical. For example, there is a well-known robust relationship between alcohol consumption and tobacco use (Bergmark, 1999;Bien and Burge, 1990;Gulliver et al, 1995;Jackson et al, 2003). In a recent study following up participants in the St. Louis Epidemiologic Catchment Area Study 16 years later, Jackson et al (2003) were able to determine a bi-directional prospective association between alcohol and tobacco use disorders.…”

Serum aminotransferase activity and mortality risk in a United States community

“…Of those, 241 (3.5%) had ALT that was greater than twice normal. The distribution of ALT was also skewed, with a mean of 29.4 (Ϯ80.9) U/L and median of 21.0 (range, 4-4860; interquartile range, [15][16][17][18][19][20][21][22][23][24][25][26][27][28][29]. In contrast to the AST data, those with ALT greater than 2 times ULN were older and more likely to be female than those with lower ALT results, although these differences were not statistically significant.…”

“…The distribution of AST was skewed to the right, with a mean of 25.7 (Ϯ37.2) and median of 21.0 (range, 4-1860; interquartile range, [17][18][19][20][21][22][23][24][25][26]. Individuals with the highest AST results were younger than the other AST groups.…”

“…The increased risk of death in that population not only may stem from alcohol-induced end organ damage (such as alcoholic liver disease) but also may be related to morbidity associated with concurrent depression, polysubstance use including tobacco products, and accidents. [22][23][24][25][26] Similarly, although hepatitis C virus infection is an important source of morbidity and mortality from liver disease, it also may be a marker of injection drug use and its associated physical, psychological, and social consequences. 27 Finally, aminotransferases can be elevated in various kinds of chronic nonhepatic disease such as muscle and thyroid disease.…”