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Title: The relationship between tobacco use, substance-use disorders and mental health: results from
    the National Survey of Mental Health and Well-being

    Author(s): Louisa Degenhardt BA(Hons); Wayne Hall PhD

    Source: Nicotine & Tobacco Research   Taylor & Francis Journals      Volume: 3 Number: 3 Page: 225 -- 234
 
    Publisher: Carfax Publishing, part of the Taylor & Francis Group
 
    Abstract: Aims: To examine comorbidity between tobacco use, substance-use disorders and mental
    health problems among Australian adults aged 18 years and over. Method: Data from the 1997
    Australian National Survey of Mental Health and Well-being were analyzed. This survey was a stratified,
    multistage probability sample of 10,641 adults, representative of the Australian population. Univariate
    associations between tobacco use, substance use and mental health were examined, and then
    multivariate analyses were conducted to control for demographic characteristics, neuroticism, and other
    drug use. Measurements: Tobacco use status was defined as: never smoker, former smoker and
    current smoker. DSM-IV diagnoses of substance use, anxiety, and affective disorders were derived
    using the Composite International Diagnostic Interview (CIDI). Other measures included a screener for
    psychosis and measures of psychological distress and disability. Findings: Current tobacco use was
    strongly associated with abuse/dependence upon alcohol, cannabis, and other substances, and with
    higher rates of anxiety and affective disorders. Current smokers were more likely to screen positively for
    psychosis and reported greater psychological distress and disability than non-smokers and never
    smokers. These higher rates of other problems were not explained by differences in demographic
    characteristics, neuroticism scores, or by other drug use. Former smokers did not have higher rates of
    affective or anxiety disorders; however, they had higher rates of alcohol-use disorders, and of
    cannabis-use disorders after adjusting for covariates. Conclusions: Current tobacco use is associated
    with a range of other substanceuse and mental health problems. These are likely to reduce the
    success of attempts to quit smoking. The presence of these other problems needs to be considered
    when considering smoking-cessation treatment, and further research may provide information on more
    effective treatment strategies for persons with co-existing substance-use and mental health problems.