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This study investigated the prevalence of past 30-day cannabis use among U.S. youth by cigarette use, alcohol use, demographics, and state-of-residence cannabis legal status in 2021 and examined whether changes in cannabis use prevalence were modified by these factors from 2013 to 2021. Data were drawn from the 24 states that collected cannabis use data participating in the Youth Risk Behavior Surveillance System from 2013 to 2021. Logistic regression analyses estimated past 30-day cannabis prevalence in 2021 and produced AORs by current cigarette, alcohol, and state-of-residence cannabis legal status. The same method was used with year as the exposure, adjusting for sex, race, and ethnicity, to assess trends in prevalence from 2013 to 2021. In 2021, cannabis use was more common among female youth (16.75% vs 13.83% [AOR=1.26, 95% CI=1.16, 1.37]) and non-Hispanic Black and Hispanic youth than among non-Hispanic White youth (17.19%, 16.14% vs 14.60% [AOR=1.25, 95% CI=1.12, 1.39 and AOR=1.16, 95% CI=1.04, 1.29, respectively]). Cannabis use was much more common among youth who reported any past 30-day cigarette or alcohol use (44.90% vs 6.48% [AOR=11.80, 95% CI=10.57, 13.18]). Declines in cannabis use were observed independent of state-level cannabis law from 2013 to 2021, and cannabis use prevalence did not differ significantly by state-of-residence cannabis legal status among the 24 participating states in 2021. Public health officials should carefully consider the potential impact of expanding commercialization of cannabis as a wellness product on youth cannabis use, especially with regard to minoritized populations and co-use with tobacco and alcohol. National and state-level public health education on cannabis use and youth-oriented prevention of cannabis uptake are long overdue. [ABSTRACT FROM AUTHOR]

Introduction: In April 2021, the United States (US) Food and Drug Administration announced its intention to issue a product standard banning menthol as a characterizing flavor in cigarettes. Given the potential relevance of national estimates of menthol use to pending legislation, this study estimated the prevalence of menthol use among US adults who smoke cigarettes in 2020 and investigated changes in menthol use from 2008-2019 by sociodemographics, mental health, and substance use.Methods: Nationally representative annual, cross-sectional data from individuals ages 18 and older residing in the US from the 2008-2019 and 2020 National Survey on Drug Use and Health (NSDUH) were analyzed using logistic and linear regression models to estimate trends in menthol use among adults who smoke cigarettes by sociodemographic, mental health and substance use variables (total analytic sample 2008-2019 n=128,327).Results: In 2020, 43.4% of adults who smoked cigarettes in the past-month used menthol. Menthol use was most common among Black adults (80%) and over 50% of those Hispanic, female, young (ages 18-34), lesbian/gay, with serious psychological distress, and with cigar use used menthol. Menthol use increased among adults who used cigarettes from 2008 to 2019, overall, and grew more rapidly among adults ages 26-34, Hispanic, light cigarette use (1-5 per day) and those who smoked cigars.Conclusions: Menthol use has increased among US adults who smoke cigarettes over the past decade. Enacting menthol bans could have a widespread public health impact, especially among younger and minoritized groups.Implications: Menthol cigarette use increased among individuals who smoke cigarettes across from 2008 to 2019 in the US. In 2020, over 40% of smokers used menthol, and menthol use was considerably higher among adult smokers from racial/ethnic minoritized groups, who were younger and who reported mental health problems. The US Food and Drug Administration seeks to ban menthol as a characterizing flavor in cigarettes; our results suggest that such ban is likely to have a wide-ranging impact on public health. [ABSTRACT FROM AUTHOR]

Introduction: Major depression is a common and potentially lethal condition. Early data suggest that the population-level burden of depression has been exacerbated by the COVID-19 pandemic. Prepandemic estimates of depression prevalence are required to quantify and comprehensively address the pandemic's impact on mental health in the U.S.Methods: Data were drawn from the 2015-2020 National Survey on Drug Use and Health, a nationally representative study of U.S. individuals aged ≥12 years. The prevalence of past-year depression and help seeking for depression were estimated from 2015 to 2019, and time trends were tested with Poisson regression with robust SEs. Point estimates were calculated for 2020 and not included in statistical trend analyses because of differences in data collection procedures.Results: In 2020, 9.2% (SE=0.31) of Americans aged ≥12 years experienced a past-year major depressive episode. Depression was more common among young adults aged 18-25 years (17.2%, SE=0.78), followed closely by adolescents aged 12-17 years (16.9%, SE=0.84). Depression increased most rapidly among adolescents and young adults and increased among nearly all sex, racial/ethnic, income, and education groups. Depression prevalence did not change among adults aged ≥35 years, and the prevalence of help seeking remained consistently low across the study period.Conclusions: From 2015 to 2019, there were widespread increases in depression without commensurate increases in treatment, and in 2020, past 12‒month depression was prevalent among nearly 1 in 10 Americans and almost 1 in 5 adolescents and young adults. Decisive action involving a multipronged public health campaign that includes evidence-based prevention and intervention to address this ongoing mental health crisis is urgently needed. [ABSTRACT FROM AUTHOR]

Introduction: Cannabis use is increasing among cigarette smokers in the United States. Prior studies suggest that cannabis use may be a barrier to smoking cessation. Yet, the extent to which this is the case among adults seeking to quit tobacco use remains unclear. Tobacco quitlines are the most common provider of no-cost treatment for adults who use smoke in the United States. This study investigated the association between cannabis use and smoking cessation outcomes among quitline callers.Aims and Methods: Participants included callers to the New York State Smokers' Quitline, who were seeking to quit smoking cigarettes and were contacted for outcome assessment 7 months after intake. Thirty-day point prevalence abstinence rates were calculated and compared among cannabis use groups, based on frequency of past-30-day cannabis use at baseline (none: 0 days, occasional: 1-9 days, regular: 10-19 days, and daily: 20-30 days).Results: Approximately 8.3% (n = 283) of participants (n = 3396) reported past-30-day cannabis use at baseline. Callers with daily cannabis use (20-30 days per month) had significantly lower odds of 30-day abstinence, relative to those who did not use cannabis (odds ratio = 0.5; 95% confidence interval [0.3, 0.9]).Conclusions: Daily cannabis use appears to be associated with poorer smoking cessation treatment outcomes among adults seeking to quit smoking cigarettes via a quitline. Because quitlines are among the most accessible, affordable, and frequently utilized community-based treatments available in the United States, and the prevalence of cannabis use is increasing among cigarette smokers, detailed inquiry into cannabis use might enhance cigarette smoking cessation outcomes.Implications: Quitlines are free of cost and accessible to millions of smokers in the United States. The current study found an inverse relationship between daily cannabis use at baseline and 30-day abstinence from cigarette smoking at 7-month follow-up among New York State Smokers' Quitline callers. Findings suggest that daily cannabis use may be a barrier to smoking cessation and sustained abstinence among those seeking help to stop smoking cigarettes. [ABSTRACT FROM AUTHOR]

Cannabis use has increased among adolescents and adults in the United States (US) in recent years. Few data are available on the prevalence of asthma by frequency of cannabis use. This study aimed to estimate the prevalence of asthma by frequency of past 30-day cannabis use among US individuals. Data were drawn from the 2020 National Survey on Drug Use and Health (NSDUH), a nationally representative, annual cross-sectional survey of US individuals aged 12 and older in the United States (N = 32,893). Logistic regression models were used to examine the relationship between frequency of any cannabis and/or blunt (i.e., cannabis smoked in a hollowed-out cigar) use in the past 30 days and current asthma, adjusting for demographics and current cigarette smoking. Current asthma was more common among US individuals who reported cannabis use in the past 30-days, relative to those who did not (9.8% vs. 7.4%, p < 0.0001). The odds of asthma was significantly greater among individuals reporting cannabis use 20–30 days/month (Adjusted Odds Ratio [AOR] = 1.67, 95% CI:1.21, 2.31), blunt use 6–15 and 20–30 days/month (AOR = 1.9, 95% CI:1.1, 3.2; AOR = 2.2, 95% CI:1.4, 3.6), respectively, than among those without. A positive linear relationship was observed between frequency of a) cannabis use (p < 0.0001) and b) blunt use (p < 0.0001) and current asthma prevalence. Findings suggest a dose-response relationship between frequency of current cannabis use and the prevalence of current asthma in the US individuals. [ABSTRACT FROM AUTHOR]

An editorial id presented on empirical perspective on cigarette use in substance use recovery. Topics include Americans with substance use disorders (SUDs), polysubstance use is the rule rather than the exception; and review of polysubstance treatment paradigms, but to highlight the lack of evidence base for the exclusion of tobacco treatment in SUD treatment settings.

Background and Aims: Cannabis use among parents may be increasing with legalization, but perception of associated risk has declined. The study investigated the association between cannabis legalization and cannabis use among adults with children in the home over time in the United States (US). Design A difference‐in‐difference approach was applied to public and restricted‐use data from the 2004–2017 National Survey on Drug Use and Health (NSDUH), an annual cross‐sectional survey. Setting: A representative sample of the United States. Participants/Cases: Respondents ages 18+ with children living in the home drawn from the NSDUH (n = 287,624), which is administered to non‐institutionalized civilians in the 50 states and District of Columbia. Measurements Exposures were year and state‐level cannabis policy in state of residence annually. Outcomes were past‐30‐day cannabis use and daily cannabis use. Sociodemographic variables included age, gender, marital status, annual family income, race/ethnicity, educational attainment, and strength of state‐level tobacco control. Findings In 2017, past‐month cannabis use (11.9%, 9.3%, and 6.1%) and daily cannabis use (4.2%, 3.2%, and 2.3%) were more common in states with recreational marijuana laws (RML), followed by states with medical marijuana laws (MML) and without legal cannabis use, respectively. RML and MML were associated with significantly higher prevalence of past‐month cannabis use (adjusted odds ratio [AOR] = 1.28, 95% confidence interval [CI] = 1.12–1.46; AOR = 1.12, 95% CI = 1.03–1.22) and daily cannabis use (AOR = 1.25, 95% CI = 1.03–1.51; AOR = 1.16, 95% CI = 1.02–1.32), respectively. The impact of MML was particularly salient among adults ages 50+ and the highest income and education subgroups. Conclusions: Among adults with children living in the home, cannabis use appears to be more common in US states with legalized cannabis use compared with states with no legal cannabis use. Recreational legalization appears to increase use among adults with children in the home broadly across nearly all sociodemographic groups, whereas the effect of legalization for medical use is heterogeneous by age and socioeconomic status. [ABSTRACT FROM AUTHOR]

We appreciate Dr. Chaiton's perspective and his thoughtful response,[1] as well as the opportunity to reply and discuss this issue further. This process should include acknowledgment that, while cigarette use has been the leading cause of preventable morbility and premature mortality for decades, tobacco use disorder has never been given a seat at the substance use disorder treatment table. [Extracted from the article]

While both direct and indirect exposure to mass trauma are increasing in the United States, relatively little is known about the potential link between mass trauma and risk of panic disorder early in life. It is also unclear whether history of prior individual trauma increases risk of panic disorder even further among those with exposure to mass trauma. The current study investigated the association between exposure to a mass trauma event (the World Trade Center (WTC) attack) and risk of panic disorder among children, how panic disorder varies by exposure severity and sociodemographic characteristics, and whether there is an interaction between individual and mass trauma exposure in the risk of panic disorder. Data were from an epidemiologic study of probable mental disorders among New York City schoolchildren exposed to the WTC terrorist attack. Severe (adjusted odds ratio [AOR] = 2.0 (1.1, 3.7)) exposure to the WTC disaster was associated with increased odds of probable panic disorder, relative to mild exposure. The prevalence of panic disorder increased with higher level of WTC exposure among all sociodemographic strata. Prior individual trauma exposure was associated with increased odds of panic disorder (AOR = 2.4 (1.6, 3.5)), but there was no evidence of interaction between prior individual trauma exposure and exposure to the WTC disaster. Preventive measures to address the widespread nature of mass disaster exposure at increasingly earlier ages and via media could mitigate the potential impact on mental health. • Severe exposure to 9/11 was associated with probable panic disorder. • Prior individual trauma was also associated with probable panic disorder. • No statistical interaction was found between individual trauma and exposure to 9/11. • Attendance at a Ground Zero school was not associated with probable panic disorder. [ABSTRACT FROM AUTHOR]

In a time of global uncertainty, understanding the psychological health of the American public is imperative. There are no current data on anxiety trends among adults in the United States (US) over time. This study aimed to investigate prevalence of anxiety among US adults from 2008 to 2018. Data from the National Survey on Drug Use and Health (NSDUH), which is an annual, cross-sectional survey on substance use and mental health in the US, were analyzed in 2020. Prevalence of past-month anxiety was estimated among those ages ≥18, by survey year from 2008 to 2018. Time trends were tested using logistic regression. Anxiety increased from 5.12% in 2008 to 6.68% in 2018 (p < 0.0001) among adult Americans. Stratification by age revealed the most notable increase from 7.97% to 14.66% among respondents 18–25 years old (p < 0.001), which was a more rapid increase than among 26–34 and 35–49 year olds (differential time trend p < 0.001). Anxiety did not significantly increase among those ages 50 and older. Anxiety increased more rapidly among those never married and with some college education, relative to their respective counterparts. Apart from age, marital status and education, anxiety increased consistently among sociodemographic groups. Anxiety is increasing among adults under age 50 in the US, with more rapid increase among young adults. To prepare for a healthier adulthood and given direct and indirect (via 24/7 media) exposure to anxiety-provoking world events, prophylactic measures that can bolster healthy coping responses and/or treatment seeking seem warranted on a broad scale. • Anxiety increased from 2008 to 2018 among American adults. • Nearly 7% of adults and 15% of young adults reported anxiety in 2018. • Anxiety increased most rapidly among young adults ages 18–25 years old. • Anxiety did not significantly increase among individuals 50 years old and older. [ABSTRACT FROM AUTHOR]

From legislatures to schools to workplaces, as well as in scientific discourse and clinical practice, the past few decades have seen a move away from labels such as "user", "addict", or "alcoholic", for their lack of precision, negative connotation, and the way they equate the person with behavior or condition. Focusing on the use of cigarettes rather than referring to "smoking" would bring greater consistency with discussion of other substance use. [Extracted from the article]

Cannabis use is increasing among adults with children in the home particularly in states with cannabis legalization for medical (MCL) and/or recreational use (RCL), relative to states where cannabis use remains illegal at the state level. Exposure to secondhand smoke is a key risk factor for asthma among children. The objective of the current study was to investigate the relationship between MCL and RCL and the state-level prevalence of asthma among children in the United States (US). This ecological study used data from the 2011to 2019 National Survey on Children's Health, a representative sample of the population of minor children in the US. Changes in the annual prevalence of pediatric asthma by RCL/MCL over time were estimated using difference-in-difference (DID) analysis. Overall, a statistically significant decrease of 1.1% in the prevalence of pediatric asthma was observed from 2011– 2012 to 2018–2019. Adjusting for sociodemographic characteristics, overall reductions in asthma over time were generally greater in states in which cannabis use is fully illegal or with recent MCL adoption, but the rate of decline did not differ statistically by RCL/MCL status. Relative to 2011–2012 and to states where cannabis is fully illegal, the prevalence of asthma increased in states with RCL among youth 12–17 years old (2018–2019 DID = 2.56, p =.028) and among youth in some NH minoritized race/ethnicity groups (2016–2017 DID = 3.88, p =.013 and 2018–2019 DID = 4.45, p =.004). More research is needed to estimate the potential consequences of increased adult use of cannabis in the community for children's respiratory health. • Childhood asthma prevalence was stable from 2017 to 19 after declining from 2011 to 17. • Childhood asthma is more common in recreational cannabis legal (RCL) states. • Childhood asthma declined were more rapidly among children in states without RCL. • Asthma increased among youth of minoritized race/ethnicity identity in RCL states. • Childhood asthma increased among adolescents in RCL states. [ABSTRACT FROM AUTHOR]

BACKGROUND: In this study, we investigated trends in cannabis use among parents with children at home in the United States and estimated changes in prevalence of any cannabis use and daily cannabis use among parents who identified as cigarette smokers and nonsmokers with children in the home from 2002 to 2015. METHODS: The National Survey on Drug Use and Health is an annual, nationally representative, cross-sectional study conducted in the United States. Using logistic regression models, associations between cigarette smoking and any past-month and daily past-month cannabis use among parents with children in the home from 2002 to 2015 were estimated. Moderation of these associations by demographics and trends over time was examined. RESULTS: Past-month cannabis use among parents with children in the home increased from 4.9% in 2002 to 6.8% in 2015, whereas cigarette smoking declined from 27.6% to 20.2%. Cannabis use increased from 11.0% in 2002 to 17.4% in 2015 among cigarette-smoking parents and from 2.4% to 4.0% among non-cigarette-smoking parents (P value for trends <.0001). Cannabis use was nearly 4 times more common among cigarette smokers versus nonsmokers (17.4% vs 4.0%; adjusted odds ratio = 3.88 [3.16-4.75]), as was daily cannabis use (4.6% vs 0.8%; adjusted odds ratio = 3.70 [2.46-5.55]). The overall percentage of parents who used either cigarettes and/or cannabis decreased from 29.7% in 2002 to 23.5% in 2015. CONCLUSIONS: Efforts to decrease secondhand smoke exposure via cigarette smoking cessation may be complicated by increases in cannabis use. Educating parents about secondhand cannabis smoke exposure should be integrated into public education programs on secondhand tobacco smoke exposure. [ABSTRACT FROM AUTHOR]

Objectives. To estimate changes in the prevalence of daily cannabis use among current, former, and never cigarette smokers from 2002 to 2014 in the United States. Methods. The National Survey on Drug Use and Health is a nationally representative cross-sectional study conducted annually among persons aged 12 years and older in the United States. Results. Daily cannabis use occurs nearly exclusively among nondaily and daily cigarette smokers compared with former and never smokers (8.03%, 9.01%, 2.79%, 1.05%, respectively). Daily cannabis use increased over the past decade among both nondaily (8.03% [2014] vs 2.85% [2002]; linear trend P < .001) and daily smokers (9.01% [2014]; 4.92% [2002]; linear trend P < .001). Daily cannabis use increased most rapidly among former cigarette smokers (2.79% [2014] vs 0.98% [2002]; linear trend P < .001). Conclusions. Daily cannabis use occurs predominantly among cigarette smokers in the UnitedStates. Daily cannabis use increasedamongcurrent, former, andneversmokersover the past decade, with particularly rapid increases among youth and female cigarette smokers. Future research is needed tomonitor the observed increase in daily cannabis use, especially among youths and adults who smoke cigarettes. [ABSTRACT FROM AUTHOR]

Background: Despite success of public health-oriented tobacco control programs in lowering the smoking prevalence over the past several decades, it is unclear whether similar reductions in smoking have been experienced among pregnant women, especially in vulnerable groups such as those with major depression and/or lower socioeconomic status.Objectives: The purpose of this study is to examine the relationship between major depressive episode (MDE) and smoking among pregnant women overall, and by demographics and to estimate changes in the prevalence of cigarette smoking among pregnant women with and without MDE from 2005 to 2014.Study Design: Cigarette use among pregnant women with and without MDE was examined using logistic regression models in the National Survey on Drug Use and Health.Results: Prenatal smoking is more common among pregnant women with, compared to without, MDE (32.5% vs. 13.0%; (adjusted OR=2.50 (1.85, 3.40)), and greater disparities were revealed when also considering income, education and race. Over time, smoking during pregnancy increased significantly among women with MDE (35.9% to 38.4%; p=0.02)) and showed a decreasing trend among women without MDE (12.5% to 9.1%; p=0.07) from 2005 to 2014.Conclusions: Over the past decade, smoking during pregnancy has increased among women experiencing a major depressive episode and is over four times more common among pregnant women with, than without, MDE. Disparities in smoking during pregnancy by MDE status and socioeconomic subgroups appear substantial. Given the multitude of risks associated with both MDE and smoking during the prenatal period, more work targeting this vulnerable and high-risk group is needed. [ABSTRACT FROM AUTHOR]

Whether making e-cigarettes widely available is a net gain, or loss, for public health is a topic of intense discussion. In sum, the two studies show that proximal effects conferred by e-cigarette use appear to be associated with reduced harm relative to cigarette use, but potentially increased harm relative to no tobacco use at all. At the same time, e-cigarette use among adolescents and young adults (AYA) with no history of nicotine use is more harmful than no tobacco product use. [Extracted from the article]

Introduction: The current study examined the relationship between acute (past 30 day) and recent (past year but not past 30 day) serious psychological distress (SPD) and smoking during pregnancy among women in the United States overall, stratified by demographic characteristics, and described the change in the prevalence of prenatal smoking among women with and without SPD, from 2008 to 2014.Methods: Data were drawn from the National Survey on Drug Use and Health (NSDUH), an annual cross-sectional study of US persons aged 12 and over. SPD and smoking in the past 30 days among pregnant women, aged 18 and older, were examined using logistic regression models. Heterogeneity in this association by demographic characteristics, trends over time, and level of cigarette consumption was also examined.Results: Prenatal smoking was common. Almost 40% of pregnant women with acute SPD reported smoking, 23% of pregnant women with recent SPD smoked, and 11.7% of pregnant women without recent SPD smoked. No significant change was found in the prevalence of prenatal smoking from 2008 to 2014 in any of these groups. Robust relationships were found between acute (OR = 5.05 [3.64-6.99]) and recent SPD (OR = 2.37 [1.74-3.24]) and smoking; these findings remained after adjusting for demographics.Conclusions: SPD and smoking during pregnancy are strongly associated; this relationship is present across all sociodemographic groups and the prevalence of smoking in pregnancy has remained relatively unchanged over the past decade both in the presence and absence of SPD.Implications: SPD and smoking in pregnancy are robustly linked; the prevalence of smoking in pregnancy is extremely high in women with SPD. Screening women with mental health problems for prenatal smoking, as well as screening pregnant smokers for mental health problems, seems warranted and may assist more women in seeking and utilizing treatment options. Efforts to reduce the prevalence of smoking during pregnancy might specifically target women with SPD, where the potential for impact is substantial. [ABSTRACT FROM AUTHOR]

Background: After declining sharply for many years, the prevalence of smoking has remained fairly stable over the past decade. One possible explanation is that there has been an increase in the prevalence of barriers to cessation, like depression, among remaining smokers.Objectives: To estimate changes in the prevalence of depression among current, former and never smokers in the United States (U.S.) population from 2005 to 2013 overall and by age, gender, and income.Methods: Data were drawn from the National Household Survey on Drug Use (NSDUH), an annual cross-sectional study of persons ages 12 and over (N=496,805). The prevalence of past 12-month depression was examined annually among current (past 12-month), former (not past 12-month), and lifetime non-smokers from 2005 to 2013. Data were re-analyzed stratified by age, gender, and household income, and adjusted for demographics.Results: Depression appears to have significantly increased in the United States from 2005 to 2013 among current, former, and never smokers. Depression prevalence increased among current smokers overall, but the increase among former and never smokers was even more prominent. Striking temporal changes emerged by age, gender and income. Specifically, (1) depression increased significantly among current smokers aged 12-17 (from 16% to 22%, p-value=0.0002) and the prevalence was consistently more than twice as high as that of never smokers; (2) depression increased among male smokers (6.19%-7.82%, p-value=0.0099); (3) depression increased significantly among smokers in the highest income group (6.36% to 8.91%, p-value=0.0400). Throughout this period, the prevalence of depression among current smokers was consistently twice as high as among former and never smokers.Discussion: Public health efforts aimed at decreasing the prevalence of smoking should take depression into account, a common and modifiable barrier whose treatment may help to increase successful smoking cessation. Future work is needed to disentangle the role of smoking and other factors that lead to increases in depression in the US population. [ABSTRACT FROM AUTHOR]

Background: Hookah use may be increasing among adults in the US. Information on the prevalence and correlates of hookah use in the adult population is relatively limited.Objectives: To determine the prevalence of current (past 30-day) and lifetime use of hookah among adults ages 18-40 in the US and to investigate the socio-demographic characteristics associated with lifetime use.Methods: Data were drawn from the Tobacco Use Supplement of the Current Population Survey data from May 2010, August 2010, and January 2011 (n = 85,545). Logistic regression was used to examine various demographic correlates of lifetime hookah use.Results: Among 18-40 year olds, the past month prevalence rate of hookah use was 0.6% and the lifetime prevalence rate of hookah use was 3.9%. Being male, non-Hispanic white, having higher levels of educational attainment, having never been married, not having any children, earning less than $20,000 annually, residing in the Midwest or western US, being a student, and being a cigarette smoker were associated with increased likelihood of lifetime hookah use. The prevalence of hookah use among current, cigarette smokers was 7.9%, more than double that of the general adult population.Conclusions: Hookah use is significantly more common among cigarette smokers and among various demographic subgroups among general adult population. Given the risks associated with hookah and poly-tobacco use, targeted public health efforts are recommended. Additionally, health-care providers may consider expanding screening tests to include hookah use. [ABSTRACT FROM AUTHOR]

Comment & Response B To the Editor b A recent study[1] showed declines in tobacco use from 2006 to 2019 among adults with and without past 12-month major depressive episode (MDE), substance use disorder (SUD), or co-occurring MDE and SUD. Results of this study[1] showed that 53.2% of adults with a drug use disorder used tobacco during the past months in 2019 vs 22.4% of those without a drug use disorder. [Extracted from the article]

Background: Preliminary research suggests an association between depression and subsequent increased risk of infections, yet little is known on this topic. This study investigated the association between depression and risk of various types of infections, including temporal and dose-response relationships.Methods: A prospective population-based study including 976,398 individuals, of whom 142,169 had a history of depression between 1995 and 2012, was conducted using linked Danish registries. Survival analyses were used to estimate the relative risk of infections among those with depression, compared with those without depression, while adjusting for gender and age.Results: Depression was associated with increased risk of a wide range of infections [incidence rate ratio (IRR) = 1.61, 95% confidence interval (CI) = 1.49-1.74, P = 0.000, for any infection]. There was no evidence of a specific temporal effect but rather a general increased risk of infection subsequent to the onset of depression, as the risk during first year (IRR = 1.67, 95% CI = 1.25-2.22, P = 0.000) remained elevated for the ensuing 11 years and beyond (IRR = 1.61, 95% CI = 1.39-1.85, P = 0.000). Dose-response analyses revealed that the risk of infection increased by 59% (IRR = 1.59, 95% CI = 1.45-1.75, P = 0.000) following a single depressive episode and was elevated even further (IRR = 1.97, 95% CI = 0.92-4.22, P = 0.082) following four or more depressive episodes. However, results did not indicate a perfect linear association.Conclusions: Findings suggest the presence of depression may confer an increased risk of infection and that this increased susceptibility is not confined to a specific time period following the onset of depression. A dose-response relationship may be present, but more research is needed to further examine and confirm a link between depression and risk of infection. [ABSTRACT FROM AUTHOR]

The overall prevalence of alcohol use disorders and drug use disorders in adolescents has been declining in recent years, yet little is known about treatment use for these disorders among adolescents. This study aimed to examine the patterns and demographics of treatment of alcohol use disorders, drug use disorders, and both conditions among U.S. adolescents. This study used publicly available data for adolescents aged 12–17 years from the annual cross-sectional surveys of the National Survey on Drug Use and Health, 2011–2019. Data were analyzed between July 2021 and November 2022. From 2011 to 2019, fewer than 11%, 15%, and 17% of adolescents with 12-month alcohol use disorders, drug use disorders, and both conditions received treatment, respectively, with significant decreases in treatment use for drug use disorders (OR=0.93; CI=0.89, 0.97; p =0.002). Overall, treatment use in outpatient rehabilitation facilities and self-help groups was most common but decreased over the course of the study period. Extensive disparities in treatment use were further identified on the basis of adolescents' gender, age, race, family structure, and mental health. To improve adolescent treatment use for alcohol and drug use disorders, assessments and engagement interventions that are gender specific, developmentally appropriate, culturally sensitive, and contextually informed are especially needed. [ABSTRACT FROM AUTHOR]

Introduction: Illicit drug use and nicotine dependence (ND) frequently co-occur. Yet, to date very few studies have examined the role of alcohol and illicit drug use in ND persistence. The objectives of this study were to investigate the relationships between specific classes of drug use, abuse, and dependence and the persistence of ND over time among adults in the United States. Methods: Data were drawn from the National Epidemiologic Survey on Alcohol and Related Conditions, a national survey of 34,653U.S. adults interviewed between 2001–2002 and reinterviewed 3 years later. Logistic regression analyses were used to investigate the relationships between various classes of drug use, abuse, and dependence among adults with ND at Wave 1 and the odds for persistent ND at Wave 2. Analyses were adjusted for differences in demographic characteristics, mood/anxiety disorders, alcohol use disorders, and other substance use disorders. Results: Lifetime drug use was not associated with significantly increased likelihood for persistent ND. Sedative abuse was associated with increased odds for nicotine persistence, but no other types of drug abuse were predictive of ND persistence, after adjusting for demographics, mood/anxiety, and alcohol use disorders. All types of drug dependence were associated with persistence of ND; the strongest associations emerged between opioid and tranquilizer dependence and persistent ND, while the associations between cannabis and cocaine dependence were no longer significant after adjusting for mood/anxiety disorders. Conclusions: Clinicians should take care to evaluate the presence and/or history of drug dependence among patients seeking treatment for smoking cessation. These data suggest that a history of substance dependence predicts increased vulnerability to persistent ND. [ABSTRACT FROM PUBLISHER]

Introduction The aim of this paper was to investigate the association between childhood and adulthood exposure to secondhand smoke (SHS) and depression, panic attack, and generalized anxiety disorder among adults in the United States over a 10-year period. Methods Data were drawn from the Midlife Development in the United States (MIDUS) Waves 1 and 2 (N=2053). Self-reported childhood and adulthood SHS exposure at Wave 1 (1994) was examined in relation to incident depression, panic attack, and generalized anxiety disorder 10 years later at Wave 2 (2005). Results Childhood SHS alone was not associated with mood and anxiety disorders in adulthood. Exposure to SHS in both childhood and adulthood was associated with increased depression and panic attack in adulthood. These associations did not appear to be due to confounding. Limitations SHS exposure was measured via self-report; biological data confirming exposure were not collected. More objective measures of SHS exposure are needed in future studies. Conclusions In summary, persistent exposure to SHS across the life course may be associated with increased risk of depression and panic attacks. Our results are consistent with prior findings and extend earlier results by showing a relationship between SHS exposure and mental health problems over time. Replication with biological measures of SHS over time is a necessary next step toward better understanding the pathways explaining these relationships. [ABSTRACT FROM AUTHOR]

Introduction: Active cigarette smoking has consistently been associated with depression, but little is known about the association between other cigarette smoke exposures, particularly in early life, and depression. We investigated whether exposures to maternal smoking during pregnancy (MSP) and childhood secondhand smoke (SHS) are associated with depressive symptoms in midlife. Methods: Pregnant mothers were enrolled and were provided data on maternal smoking and other parental characteristics. Female offspring were followed through age 7 years and again in midlife (age range = 38–44 years), when they provided data on smoking history, SHS across the life course, and current depressive symptoms using the Center for Epidemiological Studies Depression Scale (CES-D). Results: Participants exposed to MSP had a higher risk for depression (risk ratio [RR] = 1.83, 95% confidence interval [CI] = 1.08, 3.09) than those without MSP exposure. Relative to those with no MSP and no childhood SHS exposures, participants with MSP and childhood SHS had more than twice the risk of depressive symptoms (RR = 2.40, 95% CI = 1.07, 5.41). Further adjustment for adult factors, particularly current smoking, substantially reduced these associations (e.g., MSP vs. no MSP exposure: RR = 1.36 [95% CI = 0.75, 2.45]). Conclusions: Early life exposure to cigarette smoke is associated with increased risk for depression in midlife, with the association largely mediated by active smoking. These findings support a role for early life cigarette exposures in shaping smoking and depression risks in later life, and they provide some support for the direction of smoke exposure influence on depression. [ABSTRACT FROM PUBLISHER]

Abstract: Background: There is consistent evidence that hookah use is as, if not more, harmful than cigarette use. Yet, hookah users underestimate the potential deleterious effects of hookah use. This study examined the rates of hookah use and associated demographic characteristics in a sample of undergraduates at a small Northeastern university. This study also examined the relationships between hookah use and other substance use, mental health problems, and perceived levels of stress. Methods: Data were drawn from the Spring 2009 American Health Association-National College Health Assessment (ACHA-NCHA) at one small, Northeastern university (N =1799). The relationships between hookah use and other substance use, mental health problems, and perceived stress levels were examined using logistic regression analyses. Results: Hookah use (in the past month) was reported among 14.1% (253/1799) of this sample of undergraduates. Hookah users were more likely to use other substances, including cigarettes, cannabis, alcohol, cocaine, and amphetamines. The strongest associations emerged between hookah use and alcohol and cigarette use. There were no significant associations found between hookah use and any mental health problems or perceived stress levels. Conclusions: Hookah users are significantly more likely to use other substances, including alcohol, cigarettes, cannabis, cocaine, and amphetamines compared with non-hookah users. In contrast to cigarette smoking, hookah use does not appear to be associated with mental health problems or perceived stress levels in this sample of undergraduates. Further investigation into the prevalence and correlates of hookah use is needed in representative population samples. [Copyright &y& Elsevier]

Objective: To investigate the prevalence of asthma and mental health problems among representative samples of youth in high-risk service settings and the community, and to examine the relationship between asthma and mental health in these groups. Methods: Data were drawn from the Alternative Service Use Patterns of Youth with Serious Emotional Disturbance Study (SED) ( n = 1181), a combined representative, cross-sectional sample of youth in various clinical settings and the community. Multiple logistic regression analyses were used to examine the association between asthma and mental disorders. Demographic characteristics were investigated as potential confounders. Results: Asthma was common among 15.2% of youth in service settings and 18.8% of youth in the community. The prevalence of mental disorders was extremely high among youth with and without asthma in all service settings, and asthma was associated with increased prevalence of mental disorders among youth in the community, but not among youth in service settings. The relationship between asthma and internalizing disorders among youth in the community does not appear entirely attributable to confounding by demographics. Conclusions: Findings are consistent with and extend previous data by showing that both asthma and mental disorders are disproportionately common among youth in high-risk service settings. Almost half of youth with asthma in service settings meet diagnostic criteria for a mental disorder. Clinicians and policy makers who are responsible for the health care of youth in these high-risk groups should be aware that asthma is common, and that the prevalence of internalizing disorders are especially common among those with asthma. [ABSTRACT FROM AUTHOR]

Purpose: The present study investigated whether the prevalence of mood and anxiety disorders has increased over time among current smokers and whether these trends differ by gender and in comparison with nonsmokers.Methods: Data were drawn from the National Comorbidity Survey (1990) and the National Comorbidity Survey-Replication (2001), representative samples of the US adult population. Binomial regression analyses were used to determine differences between mood and anxiety disorders among current smokers in 1990 and 2001 and whether these differed by gender and in comparison with those who were former or never current smokers.Results: Any anxiety disorder, panic attacks, panic disorder, social anxiety disorder and dysthymia were all significantly more common among current smokers in 2001 compared with 1990 and except for social anxiety disorder these increases were significantly greater than any trend found in non-smokers. Increases in panic attacks, social anxiety disorder, and dysthymia were more pronounced in female than in male smokers. Major depressive disorder and generalized anxiety disorder were not found to increase over time among smokers.Conclusions: The prevalence of several anxiety disorders and dysthymia among current smokers appears to have increased from 1990 to 2001. Future studies are needed to determine whether these trends have continued. If so, interventions aimed at moving the prevalence lower may have limited success if treatment of mental health problems such as anxiety disorders and certain mood disorders are not considered in the development and dissemination of tobacco control programs. [ABSTRACT FROM AUTHOR]

Abstract: Purpose: The present study investigated whether the prevalence of mood and anxiety disorders has increased over time among current smokers and whether these trends differ by gender and in comparison with nonsmokers. Methods: Data were drawn from the National Comorbidity Survey (1990) and the National Comorbidity Survey-Replication (2001), representative samples of the US adult population. Binomial regression analyses were used to determine differences between mood and anxiety disorders among current smokers in 1990 and 2001 and whether these differed by gender and in comparison with those who were former or never current smokers. Results: Any anxiety disorder, panic attacks, panic disorder, social anxiety disorder and dysthymia were all significantly more common among current smokers in 2001 compared with 1990 and except for social anxiety disorder these increases were significantly greater than any trend found in non-smokers. Increases in panic attacks, social anxiety disorder, and dysthymia were more pronounced in female than in male smokers. Major depressive disorder and generalized anxiety disorder were not found to increase over time among smokers. Conclusions: The prevalence of several anxiety disorders and dysthymia among current smokers appears to have increased from 1990 to 2001. Future studies are needed to determine whether these trends have continued. If so, interventions aimed at moving the prevalence lower may have limited success if treatment of mental health problems such as anxiety disorders and certain mood disorders are not considered in the development and dissemination of tobacco control programs. [Copyright &y& Elsevier]

Aim The aim of this study was to examine the association between being raised in a rural setting and physical and mental health among adults in the USA. Methods Data were drawn from the National Comorbidity Survey ( n = 8098), a household probability sample representative of adults aged 15-54 years in the USA. Multiple logistic regression analyses were used to determine the association between being raised in a rural area and the likelihood of mental disorders, physical disorders, suicide behavior, and parental mental health. Odds ratios ( OR) with 95% confidence intervals were calculated, adjusting for differences in demographic characteristics. Results Being raised in a rural setting was associated with decreased odds of ulcer ( OR = 0.56 [0.34, 0.91]). Mental disorders (any lifetime) ( OR = 0.74 [0.64, 0.85]), any anxiety disorder ( OR = 0.75 [0.6, 0.92]) and any substance use disorder ( OR = 0.79 [0.65, 0.94]) were significantly less likely among adults who were raised in a rural setting. Maternal psychopathology and exposure to trauma were significantly lower among those raised in a rural setting, compared with those who were not. These relations were not explained by sociodemographic differences. Conclusions These data provide preliminary evidence that being raised in a rural environment lowers the risk of mental and physical health problems in adulthood. Being raised in a rural community also appears to be associated with significantly lower likelihood of exposure to trauma and maternal psychopathology. Future studies that can identify potential protective factors and mechanisms underlying these pathways are needed next. [ABSTRACT FROM AUTHOR]

Abstract: Background: A large number of adults report symptoms of, but do not meet diagnostic criteria for, an alcohol use disorder. Yet, little is known about the relationship between symptoms of alcohol use disorders and the initiation and persistence of smoking. This study prospectively examines the relationship between having 1–2 symptoms of alcohol dependence (without abuse) and smoking initiation and persistence as well as nicotine dependence over a 3-year period among adults in the United States. Methods: Data were drawn from Wave 1 (2001–2002) and Wave 2 (2004–2005) of the National Epidemiologic Survey on Alcohol and Related Conditions. Relationships between Wave 1 symptoms of alcohol dependence, alcohol abuse, and alcohol dependence and initiation and persistence of cigarette smoking and nicotine dependence at Wave 2 were examined using logistic regression analyses. Analyses were adjusted for demographics, mood and anxiety disorders. Results: Symptoms of alcohol dependence were associated with smoking initiation at Wave 2. There was no association between symptoms of alcohol dependence and smoking persistence. Symptoms of alcohol dependence predicted incident and persistent nicotine dependence. Findings persisted after adjusting for demographic characteristics and mood/anxiety disorders. Conclusions: Even 1–2 symptoms of alcohol dependence are associated with increased vulnerability to smoking initiation and onset and persistence of nicotine dependence at a similar strength as alcohol use disorders. Efforts at smoking cessation must address problematic alcohol use, even at the subclinical level, in order to improve efficacy. [Copyright &y& Elsevier]

Abstract: Background: Numerous studies have documented an association between mental disorders and onset of cigarette smoking. Yet, there is little understanding of the potential impact of mental disorders on trajectories of smoking over time. The objective of this study was to investigate this relationship among adolescents over a 10-year span. Methods: Data were drawn from the Early Developmental Stages of Psychopathology Study, a 10-year prospective investigation of youth in Germany. Growth mixture modeling was used to identify smoking trajectories and logistic regression analyses were used to examine relationships between mental disorders and subsequent trajectories. Results: Four trajectories were identified: non-users; increasing use; decreasing use; persistent use. Alcohol/drug use disorders, stress disorders, anxiety disorders, somatoform disorder and nicotine dependence were associated with nicotine use (as compared to the non-smoker class). However, comparisons between trajectories of nicotine use showed that any stress disorder predicted only decreasing use compared to the other two trajectories; nicotine dependence, alcohol/illicit drug use disorders as well as panic disorder and somatoform disorders were inversely associated with increasing use; nicotine dependence and alcohol/drug use disorders were associated with persistent use. Conclusions: Several mental disorders appear to be non-specific markers of the range of smoking trajectories while others predict specific trajectories. Numerous disorders (e.g., alcohol/drug use disorders) do not appear to occur only prior to and predict increased smoking trajectory as had been previously suggested, but rather they also occur concurrently, with high levels of smoking and in some cases smoking persists at a steady level over time. [Copyright &y& Elsevier]

The association between thoughts of self-harm and help-seeking among youth with symptoms of depression was examined. Data were drawn from the Health Behavior of School-aged Children Study (n = 15, 686), a nationally representative sample of youth in the United States. Analyses focused on comparing help-seeking behaviors among youth with and without thoughts of deliberate self-harm (DSH) when depressed. Depressed youth with thoughts of DSH exhibited different patterns of help-seeking than those without. Both groups most frequently sought help from friends and parents. However, adolescents with thoughts of DSH were statistically more likely than youth without to seek help from friends (DSH: 69.9%; no DSH: 57.8%; AOR = 1.46), but less likely to seek help from parents (DSH: 53.7%; no DSH: 73.1%; AOR = 0.47). Youth with DSH were more likely to seek help from school officials (AOR = 1.05), health professionals (AOR: 1.83), or a counselor (AOR = 1.93) compared with those without thoughts of DSH who were more likely to seek help from a sibling (AOR: 0.77) or other relatives (AOR: 0.78). Results may help inform programs to improve identification of youth at risk of self-harm in community and school settings. [ABSTRACT FROM AUTHOR]

The association between thoughts of self-harm and help-seeking among youth with symptoms of depression was examined. Data were drawn from the Health Behavior of School-aged Children Study ( n = 15, 686), a nationally representative sample of youth in the United States. Analyses focused on comparing help-seeking behaviors among youth with and without thoughts of deliberate self-harm ( DSH) when depressed. Depressed youth with thoughts of DSH exhibited different patterns of help-seeking than those without. Both groups most frequently sought help from friends and parents. However, adolescents with thoughts of DSH were statistically more likely than youth without to seek help from friends ( DSH: 69.9%; no DSH: 57.8%; AOR = 1.46), but less likely to seek help from parents ( DSH: 53.7%; no DSH: 73.1%; AOR = 0.47). Youth with DSH were more likely to seek help from school officials ( AOR = 1.05), health professionals ( AOR: 1.83), or a counselor ( AOR = 1.93) compared with those without thoughts of DSH who were more likely to seek help from a sibling ( AOR: 0.77) or other relatives ( AOR: 0.78). Results may help inform programs to improve identification of youth at risk of self-harm in community and school settings. [ABSTRACT FROM AUTHOR]

Aim The goal of this study was to investigate the relation between specific anxiety disorders and substance dependence, adjusting for potentially confounding demographic factors (e.g. sex) and comorbidity (e.g. alcohol dependence, major depression), among adults in the USA. Methods Data were drawn from the National Comorbidity Survey ( NCS), a nationally representative population sample of the US adult population aged 15-54. The temporal sequence of onset of anxiety and substance dependence disorders was examined. Results Substance dependence temporally precedes several anxiety disorders, particularly panic disorder. Specifically, a history of past substance dependence predicts current panic disorder (odds ratio [ OR] = 2.62, 95% confidence interval [ CI] = 1.29, 5.32), social phobia ( OR = 1.7, 95% CI = 1.12, 2.41), and agoraphobia ( OR = 1.78, 95% CI = 1.08, 2.94). Conversely, in more than 50% of substance abuse disorder cases, in nearly 40% of post-traumatic stress disorder ( PTSD) cases, and in nearly 30% of generalized anxiety disorder ( GAD) cases, the anxiety disorder has first onset. Similarly, a lifetime history of social phobia, PTSD, or GAD significantly predicts lifetime substance dependence ( OR = 1.51 for social phobia, 2.06 for PTSD, 1.45 for GAD). Conclusion For any particular anxiety disorder, a diagnosis of substance abuse can occur prior to or subsequent to an anxiety disorder. Nevertheless, there is also evidence for the specificity of some associations between anxiety and substance dependence disorders; these are independent of the effects of sex and other comorbid disorders, may be causal in nature, and deserve particular attention in clinical settings. The possibility that within a particular anxiety disorder there are a variety of mechanisms of association with various substances should be addressed in future work. [ABSTRACT FROM AUTHOR]

Abstract: Purpose: Previous studies have suggested an association between mood and anxiety disorders and peptic ulcer, yet extant work suffers from methodologic limitations. Centrally, previous epidemiologic studies have relied exclusively on self-report of ulcer. This study aimed to investigate the relationship between DSM-IV depression and anxiety disorders and physician-diagnosed ulcer among adults in the general population. Methods: Data were drawn from a population-based, representative sample of 4181 adults aged 18 to 79 in the German National Health Interview and Examination Survey. Results: Any anxiety disorder (odds ratio [OR], 2.6), panic disorder (OR, 5.2), panic attacks (OR, 3.8), and social phobia (OR, 3.3) were associated with increased likelihood of physician-diagnosed ulcer, compared with those without ulcer. There was evidence of a dose–response relationship between number of mental disorders and likelihood of current ulcer. Conclusions: These findings provide initial evidence of a link between anxiety disorders and physician-diagnosed ulcer among adults in the community. Future work, ideally taking into account Helicobacter pylori infection, stress, and mental health problems is needed to improve our understanding of the possible mechanisms that can provide insight into the etiology of peptic ulcers. [Copyright &y& Elsevier]

Abstract: Background: Suicide rates are alarmingly high among military personnel, and particularly Army National Guard soldiers. Smoking is also disproportionately common in the military. In this study, we intend to investigate the relationship between cigarette smoking and suicidal ideation among a representative sample of national guard soldiers. Methods: A representative sample of Ohio Army National Guard soldiers were followed prospectively and information was gathered on smoking, suicidal ideation and depression at baseline and one year later. Results: Smoking at baseline was associated with significantly increased likelihood of suicidal ideation at follow-up (OR=2.0 (1.3, 3.2)). This association persisted after adjusting for demographics and history of depression at baseline, but was no longer statistically significant after adjusting for depression at follow-up. Limitations: Measurement of smoking was somewhat limited. Conclusions: Army National Guard soldiers who smoke have a greater risk of subsequent suicidal ideation. Depression concurrent with suicidal ideation appears to explain this relationship. If these results are replicated, screening of soldiers who smoke may be recommended as a proactive step towards mitigating the high risk of suicide in military personnel. [Copyright &y& Elsevier]

Abstract: Although previous studies have suggested an association between various gastrointestinal disorders and mood and anxiety disorders, no previous study has examined the relationship between a diagnosis of gastritis and mood and anxiety disorders in the community. This work aimed to investigate the association between physician-diagnosed gastritis and DSM-IV mood and anxiety disorders among adults in the general population, and to examine sex differences in these relationships. Data were drawn from a population-based, representative sample of 4181 adults aged 18–79 in the German National Health Interview and Examination Survey. Anxiety disorders (27.0% vs. 15.3%) and affective disorders (20.1% vs. 11.5%) were significantly more common among adults with compared to without a diagnosis of gastritis. Lifetime and current physician diagnosed gastritis were associated with an increased prevalence of panic attacks, social phobia, any mood disorder and major depression, compared to those without gastritis. There were no significant sex differences in these associations. A diagnosis of gastritis appears to be associated with significantly increased odds of mood and anxiety disorders among adults in the general population. Contrary to findings from animal studies, we found the relationship between gastritis and mood/anxiety consistent among both sexes. [Copyright &y& Elsevier]

Background: The goal of this study was to determine the association between mental disorders and cigarette consumption and nicotine dependence. Methods: Data were drawn from the National Epidemiologic Survey of Alcohol and Related Conditions (NESARC), a nationally representative survey of adults (N = 43,093) aged 18 and older. Relationships between specific anxiety disorders, mood disorders, nondependent cigarette use, nicotine dependence among the whole sample, and nicotine dependence among cigarette users were examined. Results: After adjusting for demographics and comorbid mental disorders, generalized anxiety disorder (OR = 1.16 (1.29-1.51)), specific phobia (OR = 1.35 (1.21-1.51)), panic disorder (PD) (OR = 1.90 (1.62-2.23)), major depression (MDD) (OR = 1.31 (1.16-1.48)), and bipolar disorder (OR = 1.30 (1.09-1.54)) were associated with increased likelihood of nondependent cigarette use. Specific phobia (OR = 1.69 (1.49-1.91)), PD (OR = 1.82 (1.50-2.21)), MDD (OR = 1.59 (1.38-1.84)), and bipolar disorder (OR = 1.71 (1.39-2.09)) were associated with increased odds of nicotine dependence among the whole sample; social phobia (OR = 1.69 (1.19-2.40)), specific phobia (OR = 1.69 (1.43-2.01)), MDD (OR = 1.65 (1.34-2.02)), and bipolar disorder (OR = 2.38 (1.74-3.24)) were associated with increased risk of nicotine dependence among cigarette users. Conclusions: Specific anxiety disorders and mood disorders were uniquely associated with nondependent cigarette use, nicotine dependence among the whole sample, and the risk of nicotine dependence among cigarette users in the United States. Findings suggest that demographic differences, comorbid mood, anxiety, substance, and personality disorders all contributed to previously observed associations between mental disorders and nicotine dependence, explaining these links in some but not all cases. (Am J Addict 2012;21:416-423) [ABSTRACT FROM AUTHOR]

Abstract: Objective: Research suggests an association between nicotine dependence and anxiety/mood disorders. Yet, less is known about the role of current versus former smoking in the association between nicotine dependence and these psychiatric disorders. The purpose of the present study was to investigate the relations between anxiety/mood disorders and 1) nicotine dependence and 2) current versus former smoking. Method: Data were drawn from the 2001–2002 National Epidemiologic Survey of Alcohol and Related Conditions, a nationally representative sample of over 43,000 adults in the United States. Analyses examined whether dependent versus non-dependent smoking and current versus former smoking were associated with anxiety/mood disorders. Results: Current dependent, but not non-dependent, smoking was associated with significantly increased odds of anxiety/mood disorders. There was no association between anxiety/mood disorders and former dependent smoking, compared with never smoking. However, compared with never smoking, former non-dependent smoking was associated with significantly decreased odds of current anxiety/mood disorders. Conclusions: Current dependent smoking was positively associated with current anxiety/mood disorders, and former non-dependent smoking was negatively associated with current anxiety/mood disorders. The present research is important for understanding the relation between nicotine dependence and anxiety/mood disorders, and why it may be difficult for people with these disorders to quit smoking. The results from this study indicate that greater clinical attention could be directed toward the role of anxiety/mood disorders in smoking cessation. [Copyright &y& Elsevier]

Introduction: Previous studies have shown links between anxiety and depression and chronic obstructive pulmonary disease (COPD), but little is known about possible mechanisms of this association. The current study examined whether the observed relationship between anxiety and depression and COPD is explained by confounding due to cigarette smoking and lifetime nicotine dependence. Methods: Data were drawn from the National Comorbidity Survey Replication, a community-based representative sample of adults in the United States. Results: Analyses suggest that the association between anxiety disorders and COPD appears to be largely explained by confounding by former cigarette smoking and lifetime nicotine dependence. The association between mood disorders and COPD appears to be largely explained by confounding by lifetime nicotine dependence. Conclusions: These findings provide initial evidence suggesting that the association between anxiety, depression, and COPD may be at least partly attributable to confounding by cigarette smoking and nicotine dependence. Efforts toward prevention of chronic lung disease may be more effective if treatment and prevention efforts aimed at smoking cessation address mental health problems. [ABSTRACT FROM PUBLISHER]

Introduction: Previous studies have found an association between child abuse and respiratory disease in some populations, but the mechanisms remain unknown, and this association has not been examined in a representative community-based sample. The goal of this study was to examine the relationship between childhood physical abuse and the odds of respiratory disease and to investigate the role of depression, anxiety, and pack-years of smoking in this association. Methods: Data were drawn from the Midlife Development in the United States Survey (n = 3,032), a representative sample of adults aged 25–74 years. Multiple logistic regression analyses were used to determine the association between childhood abuse and current respiratory disease (past 12 months) and to examine whether pack-years of smoking, depression, and anxiety disorders mediated the relationship. Results: Individuals who often experienced childhood abuse had a significantly increased odds of respiratory disease (odds ratio [OR] = 1.87 [1.21, 2.90]). The association was attenuated, after adjusting for demographic characteristics and pack-years of smoking, and was no longer significant after adjusting for depression and anxiety disorders. Conclusions: These results are consistent with previous data suggesting a significant association between childhood abuse and respiratory disease and extend existing knowledge by providing initial evidence that demographic differences, depression and anxiety disorders, and lifetime cigarette smoking may mediate this observed relationship. Results require replication with longitudinal data in large community-based samples. Future studies that can explore potential biological mechanisms underlying the observed associations, such as immune factors, are needed next to better understand these relationships. [ABSTRACT FROM AUTHOR]

Abstract: Background: Evidence suggests that nicotine dependence is the key barrier to successful smoking cessation. No previous study has documented predictors of persistent nicotine dependence among adults in the community. The goal of this study is to prospectively identify predictors of continued nicotine dependence over a 3-year period among adults. Methods: Data were drawn from Waves I and II of the National Epidemiologic Survey of Alcohol and Related Conditions (NESARC), a nationally representative sample of 34,653 adults in the United States. Logistic regression analyses were used to estimate the odds of persistent nicotine dependence at Wave 2 given the presence of various sociodemographic and psychiatric predictors at Wave 1. Results: Mood, anxiety, personality and illicit substance use disorders were associated with significantly increased risk of persistent nicotine dependence. The strength of these relationships was attenuated slightly after adjusting for demographic differences, but remained statistically significant. Persistent nicotine dependence was more common among unmarried, younger females with lower income levels and lower educational attainment. Conclusions: To our knowledge, this study is the first to prospectively identify predictors of persistent nicotine dependence among adults. Our results suggest that the incorporation of mental health treatment into alternative smoking cessation approaches may help to increase the effectiveness of these programs and that a greater focus of these services on vulnerable segments of the population is needed in order to reduce continued disparities in smoking in the general population. [Copyright &y& Elsevier]

Abstract: Objective: Clinical studies suggest a familial association between panic disorder and alcohol use disorders but this relationship has not been examined in a representative community sample. The objective of this study is to examine the familial association between panic disorder and alcohol use disorders among adults in the community. Method: Data were drawn from the NESARC, a nationally representative sample of over 43,000 adults in the United States. Rates of alcohol use disorders were examined using the family history method in first-degree relatives (FDRs) of adults with panic disorder. Analyses were adjusted for demographics, alcohol use disorders in the proband, and anxiety disorders in the FDRs. Results: First-degree relatives of adults with panic disorder have significantly higher odds of alcohol use disorders, compared with FDRs of adults without panic disorder. These associations persist after adjusting for demographic characteristics, alcohol use disorders in the proband, and anxiety disorders in the FDR’s. Conclusions: Consistent with findings from clinical studies, this is the first population-based study to show a familial link between panic disorder and alcohol use disorders. This association appears independent of the influence of comorbidity of alcohol use disorders and anxiety disorders, suggesting a potential familial and/or genetic pathway. Future longitudinal studies will be needed to further understand the mechanism of this observed association. [Copyright &y& Elsevier]

Abstract: Objective: The goal of this study is to examine the association between asthma and mental disorders and the impact of asthma and mental disorder comorbidity on functional impairment and mental health care service use among adults in the community. Methods: Data came from the Canadian Community Health Survey Cycle 1.2 (N=36,984; age ≥15 years; response rate, 77%). Mental disorders were assessed using the Composite International Diagnostic Interview. Chronic physical health conditions, quality of life, and disability were also assessed. Asthma diagnoses were based on self-report of having been diagnosed with asthma by a health care professional. Results: Asthma was associated with a significantly increased likelihood of a range of mental disorders among adults in Canada, with the strongest links between asthma and posttraumatic stress disorder, mania, and panic disorder. Adults with both mental disorders and asthma had significantly higher rates of functional impairment and use of mental health services, compared with those with either asthma or mental disorders but not both. Conclusions: Our findings provide new information suggesting that adults in the community with asthma and mental disorders have higher levels of both short- and long-term health-condition-related functional disability and greater use of mental health services, compared with those with asthma without mental disorders. Results are also consistent with previous studies showing a significant link between asthma and mental disorders. Implications of these findings for efforts aimed at secondary prevention and improving treatment strategies for individuals with both asthma and mental disorders are discussed. [Copyright &y& Elsevier]

Using a sample of 781 adolescents (ages 13–17, 52.8% male) from a community survey, this study examined gender differences in the co-occurrence of specific anxiety disorders with substance use in adolescents. The associations between anxiety disorders and substance use differed according to the particular anxiety disorders and forms of substance use being examined, as well as by gender. Social phobia was associated with cigarette smoking among boys only. For girls, social phobia appeared to be negatively associated with drug use. For the other anxiety disorders, the associations with substance use tended to be stronger among girls. These findings highlight the need to improve clinical recognition of the anxiety disorders and to improve treatment access for afflicted adolescents. Future studies based on longitudinal data could further elucidate the relationships among anxiety disorders, gender, and substance use. [ABSTRACT FROM AUTHOR]