An epidemiologic analysis of co-occurring alcohol and tobacco use and disorders: findings from the National Epidemiologic Survey on Alcohol and Related Conditions

Abstract

The 2001-2002 National Epidemiologic Survey on Alcohol and Related Conditions (NESARC) sought to determine the prevalence of drinking, smoking, and associated disorders in the general population. This survey, which includes a large representative sample of the adult population of the United States, found that drinking rates were highest among young adults and declined with increasing age. Rates of smoking and co-use of alcohol and tobacco were highest among the youngest respondents and declined thereafter. Similar patterns existed for the presence of alcohol use disorders (AUDs), nicotine dependence, and comorbidity between AUDs and nicotine dependence. Among ethnic/racial groups evaluated, Whites were most likely to drink and Native Americans/Alaskan Natives were most likely to smoke and to have an AUD, nicotine dependence, or comorbid AUD and nicotine dependence. Finally, the rates of tobacco use, daily tobacco use, and nicotine dependence increased with increasing levels of alcohol consumption and the presence of an AUD. These findings have important implications for the development of prevention and intervention approaches.

Figure 1a

Prevalence of past-year alcohol and tobacco use and co-use in the United States, 2001–2002 NESARC. NOTE: Data are drawn from Table 1. The prevalence of alcohol or tobacco use only is derived as follows: % alcohol use only = % alcohol use – % co-use; % tobacco use only = % tobacco use – % co-use.

Figure 1b

Prevalence (%) of past-year alcohol use, tobacco use, and co-use by age and gender in the United States, 2001–2002 NESARC.

Figure 1c

Prevalence of past-year alcohol use, tobacco use, and co-use by race/ethnicity and gender in the United States, 2001–2002 NESARC. NOTE: Data are drawn from Table 1. W = White; B = Black; AI/AN = American Indian/Alaskan Native; A/NH/PI = Asian/Native Hawaiian/Pacific Islander; H = Hispanic.

Figure 2a

Prevalence of past-year alcohol use disorder, nicotine dependence, and comorbid disorders in the United States, 2001–2002 NESARC. NOTE 1: Data are drawn from Table 2. ND = nicotine dependence; AUD = alcohol use disorder; AD = alcohol dependence; AA = alcohol abuse. NOTE 2: The prevalence of AUDs or ND only is derived as follows: % AUD only = % AUD – % comorbid; % ND only = % ND – % comorbid.

Figure 2b

Prevalence (%) of any past-year alcohol use disorder, nicotine dependence, and comorbid disorders by age and gender in the United States, 2001–2002 NESARC. NOTE 1: Data are drawn from Table 2. AUD = alcohol use disorder; ND = nicotine dependence. NOTE 2: The prevalence of AUD or ND only is derived as follows: % AUD only = % AUD – % comorbid; % ND only = % ND – % comorbid.

Figure 2c

Prevalence (%) of any past-year alcohol use disorder, nicotine dependence, and comorbid disorders by race/ethnicity and gender in the United States, 2001–2002 NESARC. NOTE: Data are drawn from Table 2. W = White; B = Black; AI/AN = American Indian/Alaskan Native; A/NH/PI = Asian/Native Hawaiian/Pacific Islander; H = Hispanic; AUD = alcohol use disorder; ND = nicotine dependence.

Figure 3

A Prevalence of past-year tobacco use by past-year drinking characteristics and gender in the United States, 2001–2002 NESARC. B Prevalence of past-year daily tobacco use by past-year drinking characteristics and gender in the United States, 2001–2002 NESARC. C Prevalence of past-year nicotine dependence by past-year drinking characteristics and gender in the United States, 2001–2002 NESARC. NOTE: Data are drawn from Table 3. LA = lifetime abstainer; FD = former drinker; L = light drinker; M = moderate drinker; H = heavy drinker; AA = alcohol abuse; AD = alcohol dependence.