Cited by 87Smoking Behavior and CessationSubstance Abuse Treatment and OutcomesChild and Adolescent Psychosocial and Emotional Development

Mental health problems and onset of tobacco use among 12- to 24-year-olds in the PATH study.

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Green, Victoria R., Conway, Kevin P., Silveira, Marushka L., Kasza, Karin A., Cohn, Amy, Cummings, K. Michael, Stanton, Cassandra A., Callahan-Lyon, Priscilla +12 more·2018·Journal of the American Academy of Child & Adolescent Psychiatry

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 internalizing (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 tobacco (AOR = 1.6, 95% CI = 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 externalizing 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.

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  1. [7]Substance A, Mental Health Services A, Office of the Surgeon G. Reports of the Surgeon General Facing Addiction in America: The Surgeon General’s Report on Alcohol, Drugs, and Health. Washington (DC): US Department of Health and Human Services; 2016. 28252892
  2. [28]Judkins DR. Fay’s method for variance estimation. J. Off. Stat. 1990; 6: 223– 239.
  3. [31]Conway KP, Green VR, Kasza KA, 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. Addict Behav. 1 2018; 76: 208– 217. 28846942 PMC7551590
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Authors
Green, V. R., Conway, K. P., Silveira, M. L., Kasza, K. A., Cohn, A., Cummings, K. M., Stanton, C. A., Callahan-Lyon, P., Slavit, W., Sargent, J. D., Hilmi, N., Niaura, R. S., Reissig, C. J., Lambert, E., Zandberg, I., Brunette, M. F., Tanski, S. E., Borek, N., Hyland, A. J., & Compton, W. M.
Affiliations
  • National Institutes of Health (US)
  • Roswell Park Comprehensive Cancer Center (US)
  • Truth Initiative (US)
  • Medical University of South Carolina (US)
  • Westat (United States) (US)
  • United States Food and Drug Administration (US)
  • Dartmouth College (US)
Corresponding author
Silveira, Marushka L.
Venue
Journal of the American Academy of Child & Adolescent Psychiatry
Publisher
Elsevier BV
Published
2018-12
Volume
57
Issue
12
Pages
944-954.e4
ISSN
0890-8567 (ISSN-L)
OpenAlex
W2895078221
Cited by
86
References
37
Citations by year
2026: 2 · 2025: 15 · 2024: 20 · 2023: 14 · 2022: 10 · 2021: 10 · 2020: 9 · 2019: 6
FWCI
4.30
Type
journal article
Language
en
Update notices
erratum (2025-04-01)
Open access
Locations
  • Journal of the American Academy of Child & Adolescent Psychiatry (publishedVersion)
  • PubMed (publishedVersion)
  • PubMed Central (acceptedVersion)
  • Lincoln (University of Nebraska) (submittedVersion)
Funders
  • National Institute on Drug Abuse
  • National Institutes of Health
  • Center for Tobacco Products
  • Food and Drug Administration
  • Department of Health and Human Services (HHSN271201100027C)
Topics
  • Health Sciences › Medicine › Physiology › Smoking Behavior and Cessation
  • Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
  • Social Sciences › Psychology › Clinical Psychology › Child and Adolescent Psychosocial and Emotional Development
Keywords
mental illness, internalizing problems, externalizing problems, youth and young adults, electronic cigarettes, cigarillos, cigarettes, smokeless tobacco, hookah, tobacco use screening, mental health screening, PATH Study
MeSH terms
Adolescent, Adult, Age Factors, Mental Disorders, Child, Female, Humans, Longitudinal Studies, Male, United States, Cohort Studies, Substance-Related Disorders, Young Adult, Self Report, Tobacco Products, Tobacco Use, Electronic Nicotine Delivery Systems

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