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The Epidemiology of DSM-5 Nicotine Use Disorder: Results From the National Epidemiologic Survey on Alcohol and Related Conditions-III

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Chou, S. Patricia, Goldstein, Risë B., Smith, Sharon M., Huang, Boji, Ruan, W. June, Zhang, Haitao, Jung, Jeesun, Saha, Tulshi D. +2 more·2016·The Journal of Clinical Psychiatry
DOI 10.4088/jcp.15m10114PMC PMC8154113
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Abstract

OBJECTIVE: To present nationally representative information on the prevalence, correlates, psychiatric comorbidity, and treatment of DSM-5 nicotine use disorder (NUD) and the public health burden of US cigarette consumption among adults with NUD and other psychiatric disorders. METHODS: Using data from the 2012-2013 National Epidemiologic Survey on Alcohol and Related Conditions-III (N = 36,309), we conducted weighted cross-tabulations and multivariate logistic regression analyses to estimate prevalences and examine comorbidity of NUD. RESULTS: Prevalences of 12-month and lifetime DSM-5 NUD were 20.0% and 27.9%, respectively. Nicotine use disorder was more frequent among men, non-Hispanic whites, younger individuals, the previously married, those with less education and lower incomes, and those residing in rural areas. Adjusting for sociodemographic characteristics and additional psychiatric comorbidity, 12-month NUD and lifetime NUD were significantly associated with other substance use and antisocial personality disorders (odds ratios [ORs] = 1.5-5.1, 12-month; 1.5-5.6, lifetime). Twelve-month severe NUD was generally associated with major depressive, bipolar I, bipolar II, panic, generalized anxiety, posttraumatic stress, and schizotypal, borderline, and antisocial personality disorders (ORs = 1.3-2.5). Individuals with current NUD and at least 1 psychiatric disorder comprised 11.1% of US adults but smoked 53.6% of total cigarettes consumed. Treatment was utilized by 20.3% of respondents with 12-month and 18.8% with lifetime NUD. CONCLUSIONS: Findings underscore the need to address nicotine use in clinical settings. Recognition of psychiatrically vulnerable subpopulations may inform etiologic research, prevention, and treatment of NUD.

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Crossref · 10.4088/jcp.15m10114

Cites

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  • Although SUDs remain more prevalent in men than in women, the gender gap has been narrowing, possibly in part due to changes in gender roles.

    “Although SUDs remain more prevalent in men than in women, the gender gap has been narrowing 150,328- 330 , possibly in part due to changes in gender roles 331 .”

    From Substance use disorders: a comprehensive update of classification, epidemiology, neurobiology, clinical aspects, treatment and prevention (2023) · cites this paper as [329]

    The Results section reports that odds of nicotine use disorder were greater among men, and the Discussion says rates were higher among men, consistent with other substance use disorders. The paper does not report that the gender gap has narrowed; its comparison with 2001–2002 gives overall rates, not a change in the gap. The gender-roles explanation is attached to a different citation in the citing sentence. (LLM, conf=0.87)

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  • Adjusted odds ratios for lifetime nicotine use disorder are 1.57 for bipolar I disorder and 1.22 for bipolar II disorder.

    “For lifetime NUD, figures were 1.57 (CI: 1.29–1.90) for BD-I and 1.22 (CI: 0.77–1.95) for BD-II, respectively.”

    From The detrimental effects of smoking on the course and outcome in adults with bipolar disorder—A narrative review (2023) · cites this paper as [15]

    The Results section (Comorbidity of NUD; page unavailable) reports an adjusted positive association between lifetime NUD and bipolar I disorder, and discusses bipolar II associations by NUD severity. The passages in our copy do not give the claimed odds ratios of 1.57 and 1.22 or their confidence intervals, so the numerical attribution cannot be confirmed. (LLM, conf=0.78)

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  • Adjusted odds ratios for 12-month DSM-5 nicotine use disorder are 1.93 for bipolar I disorder and 1.05 for bipolar II disorder.

    “Chou and colleagues (15) reported adjusted odds ratios for 12-month DSM-5 NUD of 1.93 (CI: 1.49–2.50) for BD-I, and 1.05 (CI: 0.67–1.64) for BD-II.”

    From The detrimental effects of smoking on the course and outcome in adults with bipolar disorder—A narrative review (2023) · cites this paper as [15]

    The Results (Comorbidity of NUD; page unavailable) report an adjusted positive association between 12-month NUD and bipolar I disorder, while bipolar II associations differ by NUD severity. Our copy does not give the claimed odds ratios of 1.93 and 1.05 or their confidence intervals, so the specific numerical claim cannot be verified. (LLM, conf=0.77)

    Experimental — accuracy not yet measured

  • Adjusted odds ratios for severe 12-month DSM-5 nicotine use disorder are 2.53 for bipolar I disorder and 1.85 for bipolar II disorder.

    “Looking into severe NUD as defined by DSM-5 only, 12-month DSM-5 NUD adjusted odds ratio was 2.53 (CI:1.87–3.42) for BD-I, and 1.85 (CI:1.07–3.21) for BD-II.”

    From The detrimental effects of smoking on the course and outcome in adults with bipolar disorder—A narrative review (2023) · cites this paper as [15]

    The Results section (Comorbidity of NUD; page not available) reports positive adjusted associations between severe 12-month DSM-5 nicotine use disorder and both bipolar I and bipolar II disorder. The Abstract Results gives a general odds-ratio range of 1.3–2.5, but the passages in our copy do not provide the specific odds ratios of 2.53 and 1.85 or their confidence intervals; searches for those numbers did not find them. (LLM, conf=0.84)

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Cites

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Research works printed but not linked: 3

  1. [22]American Psychiatric Association Diagnostic and Statistical Manual of Mental Disorders 5 (DSM-5) Arlington, VA American Psychiatric Press 2013
  2. [28]Grant BF Goldstein RB Chou SP The Alcohol Use Disorder and Associated Disabilities Interview Schedule – Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition Version (AUDADIS-5) Rockville, MD National Institute on Alcohol Abuse and Alcoholism 2011
  3. [30]Hasin DS Aivadyan C Greenstein E Grant BF Psychiatric Research Interview for Substance Use and Mental Disorders, Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (PRISM-5) Version New York, NY Columbia University, Department of Psychiatry 2011

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Related

Authors
Chou, S. P., Goldstein, R. B., Smith, S. M., Huang, B., Ruan, W. J., Zhang, H., Jung, J., Saha, T. D., Pickering, R. P., & Grant, B. F.
Affiliations
National Institutes of Health (US)
ORCID
Venue
The Journal of Clinical Psychiatry
Publisher
Physicians Postgraduate Press, Inc
Published
2016-04-26
Volume
77
Issue
10
Pages
1404-1412
ISSN
0160-6689 (ISSN-L)
DOI
10.4088/jcp.15m10114
PMC
PMC8154113
OpenAlex
W2345309666
Cited by
106
References
44
Citations by year
2026: 5 · 2025: 4 · 2024: 8 · 2023: 11 · 2022: 8 · 2021: 13 · 2020: 18 · 2019: 18 · 2018: 17 · 2017: 2 · 2016: 1 · 2015: 1
FWCI
10.20
Type
journal article
Language
en
Open access
Locations
  • The Journal of Clinical Psychiatry (publishedVersion)
  • PubMed (publishedVersion)
  • PubMed Central (acceptedVersion)
Funders
National Institutes of Health (Z99‐AA999999)
Topics
  • Health Sciences › Medicine › Physiology › Smoking Behavior and Cessation
  • Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
  • Social Sciences › Psychology › Clinical Psychology › Gambling Behavior and Treatments
Keywords
nicotine use disorder, DSM-5, prevalence, psychiatric comorbidity, substance use disorders, antisocial personality disorder, major depressive disorder, bipolar disorder, anxiety disorders, post-traumatic stress disorder, schizotypal personality disorder, borderline personality disorder, smoking, public health burden, treatment utilization, sociodemographic factors
MeSH terms
Adolescent, Adult, Age Factors, Aged, Alcoholism, Mental Disorders, Cross-Sectional Studies, Female, Health Surveys, Humans, Male, Middle Aged, Risk Factors, Smoking, Statistics as Topic, Tobacco Use Disorder, United States, Comorbidity, Smoking Cessation, Diagnostic and Statistical Manual of Mental Disorders, Young Adult

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