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

Authors

Kevin P. Conway, National Institutes of Health, BethesdaFollow
Victoria R. Green, National Institutes of Health, Bethesda & Kelly Government Solutions
Karin A. Kasza, Roswell Park Cancer Institute, Buffalo
Marushka L. Silveira, National Institutes of Health, Bethesda & Kelly Government Solutions
Nicolette Borek, Center for Tobacco Products, Food and Drug Administration
Heather L. Kimmel, National Institutes of Health, Bethesda
James D. Sargent, Norris Cotton Cancer Center, Lebanon
Cassandra A. Stanton, Westat, Rockville, MD
Elizabeth Lambert, National Institutes of Health, Bethesda
Nahla Hilmi, National Institutes of Health, Bethesda & Kelly Government Solutions
Chad J. Reissig, Center for Tobacco Products, Food and Drug Administration
Kia J. Jackson, Center for Tobacco Products, Food and Drug Administration
Susanne E. Tanski, Norris Cotton Cancer Center, Lebanon
David Maklan, Westat, Rockville, MD
Andrew J. Hyland, Roswell Park Cancer Institute, Buffalo
Wilson M. Compton, National Institutes of Health, Bethesda

Date of this Version

2018

Document Type

Article

Citation

U.S. government works are not subject to copyright.

Comments

Addictive Behaviors 76 (2018) 208–217

http://dx.doi.org/10.1016/j.addbeh.2017.08.009

Abstract

Introduction: Cigarette use is associated with substance use and mental health problems among youth, but as- sociations 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 12–17 years from Wave 1 (2013–2014) of the nationally representative Population Assessment of Tobacco and Health (PATH) Study. Participants self-reported ever cigarette, e-cigar- ette, smokeless tobacco, traditional cigar, cigarillo, filtered cigar, hookah, and other tobacco product use; al- cohol, 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 pro- blems and tobacco users were more likely to report internalizing (AOR = 1.6, 95% CI: 1.4–1.8) and ex- ternalizing (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.