Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2018 Jan:76:208-217.
doi: 10.1016/j.addbeh.2017.08.009. Epub 2017 Aug 18.

Co-occurrence of tobacco product use, substance use, and mental health problems among youth: Findings from wave 1 (2013-2014) of the population assessment of tobacco and health (PATH) study

Kevin P Conway  1 , Victoria R Green  2 , Karin A Kasza  3 , Marushka L Silveira  2 , Nicolette Borek  4 , Heather L Kimmel  5 , James D Sargent  6 , Cassandra A Stanton  7 , Elizabeth Lambert  5 , Nahla Hilmi  2 , Chad J Reissig  4 , Kia J Jackson  4 , Susanne E Tanski  6 , David Maklan  7 , Andrew J Hyland  3 , Wilson M Compton  5
Affiliations

Co-occurrence of tobacco product use, substance use, and mental health problems among youth: Findings from wave 1 (2013-2014) of the population assessment of tobacco and health (PATH) study

Kevin P Conway et al. Addict Behav. 2018 Jan.

Abstract

Introduction: Cigarette use is associated with substance use and mental health problems among youth, but associations are unknown for non-cigarette tobacco product use, as well as the increasingly common poly-tobacco use.

Methods: The current study examined co-occurrence of substance use and mental health problems across tobacco products among 13,617 youth aged 12-17years from Wave 1 (2013-2014) of the nationally representative Population Assessment of Tobacco and Health (PATH) Study. Participants self-reported ever cigarette, e-cigarette, smokeless tobacco, traditional cigar, cigarillo, filtered cigar, hookah, and other tobacco product use; alcohol, marijuana, and other drugs; and lifetime substance use, internalizing and externalizing problems.

Results: In multivariable regression analyses, use of each tobacco product was associated with substance use, particularly cigarillos and marijuana (AOR=18.9, 95% CI: 15.3-23.4). Cigarette (AOR=14.7, 95% CI: 11.8-18.2) and cigarillo (AOR=8.1, 95% CI: 6.3-10.3) use were strongly associated with substance use problems and tobacco users were more likely to report internalizing (AOR=1.6, 95% CI: 1.4-1.8) and externalizing (AOR=1.4, 95% CI: 1.3-1.6) problems. Female tobacco users were more likely to have internalizing problems than male tobacco users. Poly-tobacco users were more likely than exclusive users to use substances (AOR=3.4, 95% CI: 2.7-4.3) and have mental health (AOR=1.2, 95% CI: 1.0-1.5) and substance use (AOR=4.7, 95% CI: 3.4-6.6) problems.

Conclusions: Regardless of the tobacco product used, findings reveal high co-occurrence of substance use and mental health problems among youth tobacco users, especially poly-tobacco users. These findings suggest the need to address comorbidities among high risk youth in prevention and treatment settings.

Keywords: Adolescent; Cannabis; Epidemiologic studies; Mental health; Tobacco.

PubMed Disclaimer

Conflict of interest statement

Conflict of interest disclosures

W.M. Compton declares ownership of stock in General Electric Co, 3M Co, and Pfizer Inc, unrelated to the submitted work. No other potential conflicts of interest were reported.

Figures

Fig. 1.
Fig. 1.
Ever substance use (%) and lifetime high severity mental health problems (%) among youth poly-tobacco ever users versus exclusive ever tobacco users, PATH study, 2013–2014.
See this image and copyright information in PMC

References

    1. Armstrong TD, & Costello EJ (2002). Community studies on adolescent substance use, abuse, or dependence and psychiatric comorbidity. Journal of Consulting and Clinical Psychology, 70, 1224–1239. - PubMed
    1. Arrazola RA, Singh T, Corey CG, Husten CG, Neff LJ, Apelberg BJ, … Caraballo RS (2015). Tobacco use among middle and high school students - United States, 2011–2014. MMWR. Morbidity and Mortality Weekly Report, 64, 381–385. - PMC - PubMed
    1. Bélanger RE, Marclay F, Berchtold A, Saugy M, Cornuz J, & Suris J-C (2013). To what extent does adding tobacco to cannabis expose young users to nicotine? Nicotine & Tobacco Research, 15, 1832–1838. - PubMed
    1. Brinkman WB, Epstein JN, Auinger P, Tamm L, & Froehlich TE (2015). Association of attention-deficit/hyperactivity disorder and conduct disorder with early tobacco and alcohol use. Drug and Alcohol Dependence, 147, 183–189. - PMC - PubMed
    1. Camenga DR, & Klein JD (2016). Tobacco use disorders. Child and Adolescent Psychiatric Clinics of North America, 25, 445–460. - PMC - PubMed

MeSH terms