Mental Health Problems and Onset of Tobacco Use Among 12- to 24-Year-Olds in the PATH Study

Authors

Victoria R. Green MHS, National Institutes of Health, Bethesda & Kelly Government Solutions, Rockville
Kevin P. Conway PhD, CHES, National Institutes of Health, Bethesda
Marushka L. Silveira BDS, MPH, PhD, National Institutes of Health, Bethesda & Kelly Government Solutions, Rockville
Karin A. Kasza MA, Roswell Park Cancer Institute, Buffalo
Amy Cohn PhD, Truth Initiative, Washington
K. Michael Cummings PhD, MPH, Medical University of South Carolina, Charleston
Cassandra A. Stanton PhD, Westat, Rockville
Priscilla Callahan-Lyon MD, Food and Drug Administration, Silver Spring
Wendy Slavit MPH, CHES, Food and Drug Administration, Silver Spring
James D. Sargent MD, Geisel School of Medicine at Dartmouth
Nahla Hilmi MPH, National Institutes of Health, Bethesda & Kelly Government Solutions, Rockville
Raymond S. Niaura PhD, Truth Initiative, Washington
Chad J. Reissig PhD, Food and Drug Administration, Silver Spring
Elizabeth Lambert MA, National Institutes of Health, Bethesda
Izabella Zandberg PhD, Food and Drug Administration, Silver Spring
Mary F. Brunette MD, Geisel School of Medicine at Dartmouth
Susanne E. Tanski MD, Geisel School of Medicine at Dartmouth
Nicolette Borek PhD, Food and Drug Administration, Silver Spring
Andrew J. Hyland PhD, Roswell Park Cancer Institute, Buffalo
Wilson M. Compton MD, MPE, National Institutes of Health, Bethesda

Date of this Version

2018

Document Type

Article

Citation

J Am Acad Child Adolesc Psychiatry 2018;57(12):944-954.

Comments

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

Abstract

Objective: To examine whether mental health problems predict incident use of 12 different tobacco products in a nationally representative sample of youth and young adults.

Method: This study analyzed Wave (W) 1 and W2 data from 10,533 12- to 24-year-old W1 never tobacco users in the Population Assessment of Tobacco and Health (PATH) Study. Self-reported lifetime internalizing and externalizing symptoms were assessed at W1. Past 12-month use of cigarettes, electronic nicotine delivery systems (ENDS), traditional cigars, cigarillos, filtered cigars, pipe, hookah, snus pouches, other smokeless tobacco, bidis and kreteks (youth only), and dissolvable tobacco was assessed at W2.

Results:In multivariable regression analyses, high-severity W1 interalizing (adjusted odds ratio [AOR] = 1.5, 95% CI = 1.3 - 1.8) and externalizing (AOR=1.3, 95% CI=1.1-1.5) problems predicted W2 onset of any tobacco use compared to no/low/moderate severity. High-severity W1 internalizing problems predicted W2 use onset across most tobacco products. High-severity W1 externalizing problems predicted onset of any tabacco (AOR=1.6, 95% C1=1.3-1.8), cigarettes (AOR=1.4, 95% CI=1.0-2.0), ENDS (AOR=1.8, 95& CI=1.5-2.1), and cigarillos (AOR=1.5, 95% CI=1.0-2.1) among youth only.

Conclusion: Internalizing and externalizing problems predicted onset of any tobacco use. However, findings differed for internalizing and exter- nalizing problems across tobacco products, and by age, gender, and race/ethnicity. In addition to screening for tobacco product use, health care providers should screen for a range of mental health problems as a predictor of tobacco use. Interventions addressing mental health problems may prevent youth from initiating tobacco use.