Psychiatric disorders and stages of smoking
Abstract
Background We examined the role of DSM-III-R psychiatric disorders in predicting the subsequent onset of daily smoking, smokers' progression to nicotine dependence, and the persistence of smoking.Methods The Tobacco Supplement of the National Comorbidity Survey was administered to a representative subsample of 4414 persons 15-54 years of age. DSM-III-R psychiatric disorders and information on age of onset of psychiatric disorders, daily smoking, and smoking cessation were ascertained with the World Health Organization's Composite International Diagnostic Interview.Results Preexisting psychiatric disorders that have not remitted (i.e., active disorders) predicted an increased risk for the first onset of daily smoking and for smokers' progression to nicotine dependence. The increased risk applied across most of the disorders examined in the study, including major depression, anxiety disorders, and substance use disorders. Persons with four or more active disorders were at higher risk for daily smoking (2.1 vs. 1.4) and for nicotine dependence (2.9 vs. 1.4) than were persons with one active disorder. With few exceptions, remitted (i.e., past) disorders did not predict the subsequent onset of daily smoking. Preexisting psychiatric disorders did not influence smokers' potential for quitting; the persistence of smoking in the year preceding the interview was unrelated to history of psychiatric disorders.Conclusions The results suggest the possibility of additional and previously unrecognized public health benefits of early treatment of mental disorders, in that persons with various mental disorders whose illness had remitted were not at increased risk for daily smoking, in contrast with persons with active disorders.
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A bidirectional link exists between nicotine dependence and anxiety disorders.
“Numerous studies have identified a bidirectional link between nicotine dependence and anxiety disorders (Breslau, Davis, & Schultz, 2003; Breslau et al., 2004; Feldner, Babson, & Zvolensky, 2007; Fu et al., 2007; Koenen et al., 2005).”
From Nicotine addiction and psychiatric disorders (2015) · cites this paper as Breslau et al., 2004
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- Authors
- Breslau, N., Novak, S. P., & Kessler, R. C.
- Affiliations
- Henry Ford Health (US)
- Brown University (US)
- Harvard University (US)
- Venue
- Biological Psychiatry
- Publisher
- Elsevier BV
- Published
- 2004-01
- Volume
- 55
- Issue
- 1
- Pages
- 69-76
- ISSN
- 0006-3223 (ISSN-L)
- OpenAlex
- W2018984282
- Cited by
- 274
- References
- 56
- Citations by year
- 2026: 1 · 2025: 3 · 2024: 5 · 2023: 1 · 2022: 1 · 2021: 4 · 2020: 2 · 2019: 11 · 2018: 6 · 2017: 6 · 2016: 19 · 2015: 17 · 2014: 18 · 2013: 12 · 2012: 22
- FWCI
- 6.72
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Biological Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Funders
- William T. Grant Foundation (90135190)
- National Cancer Institute (R25 CA87972)
- National Institute of Mental Health (RO1 MH52861, R01 MH49098, K05 MH00507)
- National Institute on Drug Abuse (R01 MH46376)
- Topics
- Health Sciences › Medicine › Physiology › Smoking Behavior and Cessation
- Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
- Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
- Keywords
- mental illness, smoking onset, nicotine dependence, smoking cessation, smoking persistence, DSM-III-R, major depressive disorder, anxiety disorders, substance use disorders, comorbidities, tobacco use
- MeSH terms
- Adolescent, Adult, Mental Disorders, Female, Humans, Male, Middle Aged, Severity of Illness Index, Smoking, Tobacco Use Disorder, Comorbidity, Diagnostic and Statistical Manual of Mental Disorders
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