Co-occurrence of tobacco product use, substance use, and mental health problems among adults: Findings from Wave 1 (2013–2014) of the Population Assessment of Tobacco and Health (PATH) Study

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 32,202 U.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.

Cigarette smoking quit ratios among adults in the USA with cannabis use and cannabis use disorders, 2002–2016

“…Sixth, this study examined cigarette smoking and non-use of other nicotine or tobacco products (eg, cigars, electronic cigarettes) or co-use of cigarettes and other tobacco products. Cannabis use is associated with use of a range of tobacco products beyond cigarettes including hookah, cigars and e-cigarettes (eg, ref 71 72…”

“…Cigarette smoking is a leading cause of mortality and morbidity in the USA and around the world 1–3. While the prevalence of smoking has decreased over time,3–5 smoking remains common among some subgroups of smokers such as persons with illicit drug use 6–8. High prevalence is driven by more rapid smoking initiation and/or by lower smoking cessation.…”

“…Persons who smoke cigarettes are significantly more likely to report cannabis use and CUDs8 19 25 26 and, conversely, persons who use cannabis and have CUDs are more likely to report cigarette smoking 6 24 26–28. The use of cannabis and cigarettes together is associated with a range of adverse physical, psychological, cognitive and social consequences as well as an increased likelihood of CUDs, less confidence in quitting and readiness to quit cannabis, and less success with abstinence from cannabis 29–33.…”

Relationship between Healthy Habits and Perceived Motivational Climate in Sport among University Students: A Structural Equation Model

“…This is a persistent social issue that has negative effects on health outcomes [8]. It is therefore important to establish risk factors related to excessive drinking at the university stage.…”

Cigarette smoking, depressive symptoms, and social cognitions

“…There is comorbidity between depression and smoking (Conway et al, 2017;Polednak, 2014;Weinberger et al, 2016). Richardson, He, Curry, and Merikangas (2012) 2013 for those who experienced depression and were current smokers.…”