1
|
Gaiha SM, Wang M, Baiocchi M, Halpern-Felsher B. Depression screening outcomes among adolescents, young adults, and adults reporting past 30-day tobacco and cannabis use. Addict Behav 2024; 156:108076. [PMID: 38838604 PMCID: PMC11208074 DOI: 10.1016/j.addbeh.2024.108076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2024] [Revised: 05/02/2024] [Accepted: 05/26/2024] [Indexed: 06/07/2024]
Abstract
BACKGROUND Few studies examine the relationship between depression and use of specific tobacco and/or cannabis products among adolescents, young adults, and adults. We determined whether the odds of depression are greater among those who used specific tobacco and/or cannabis products and among co-users of tobacco and cannabis. METHOD Cross-sectional online survey of a national convenience sample of 13-40-year-olds (N = 6,038). The survey included depression screening and past 30-day use of specific tobacco and cannabis products (cigarettes; e-cigarettes, vaped cannabis, little cigars, cigarillos, cigars, hookah, chewing tobacco, smoked cannabis, edible cannabis, blunts). Analyses correspond to the total sample, and 13-17-, 18-24-, and 25-40-year-olds. RESULTS Among 5,281 individuals who responded to the depression screener and nine product use questions, 1,803 (34.1 %) reported co-use of at least one tobacco product and one cannabis product in the past 30 days. Past 30-day co-use was associated with higher likelihood of screening positive for depression compared to past 30-day use of tobacco-only (aOR = 1.32, 1.06-1.65; 0.006) or cannabis-only (aOR = 1.94, 1.28-2.94; <0.001). Screening positive for depression was more likely among those who reported past 30-day use of e-cigarettes (aOR = 1.56; 1.35-1.80; <0.001), cigarettes (aOR = 1.24, 1.04-1.48; 0.016), chewed tobacco (aOR = 1.91, 1.51-2.42; <0.001), and blunts (aOR = 1.22, 1.00-1.48; 0.053) compared to those who did not report past 30-day use of these products. Among the 2,223 individuals who screened positive for depression, the most used two-product combination was nicotine e-cigarettes and smoked cannabis (614 individuals, 27.6 %). CONCLUSIONS Screening positive for depression was more likely among past 30-day co-users versus past 30-day users of tobacco-only or cannabis-only. Findings suggest that prevention programs for depression and substance use address tobacco and cannabis co-use.
Collapse
Affiliation(s)
- Shivani Mathur Gaiha
- Stanford REACH Lab, Division of Adolescent Medicine, Department of Pediatrics, Stanford University School of Medicine, CA, United States; Division of Adolescent/Young Adult Medicine, Department of Pediatrics, Boston Children's Hospital, Boston, United States; Faculty of Pediatrics, Harvard Medical School, Boston, United States
| | - Maggie Wang
- Department of Biomedical Data Science, Stanford University, CA, United States
| | - Mike Baiocchi
- Stanford REACH Lab, Division of Adolescent Medicine, Department of Pediatrics, Stanford University School of Medicine, CA, United States
| | - Bonnie Halpern-Felsher
- Stanford REACH Lab, Division of Adolescent Medicine, Department of Pediatrics, Stanford University School of Medicine, CA, United States.
| |
Collapse
|
2
|
Johnstad PG. Unhealthy behaviors associated with mental health disorders: a systematic comparative review of diet quality, sedentary behavior, and cannabis and tobacco use. Front Public Health 2024; 11:1268339. [PMID: 38249418 PMCID: PMC10797041 DOI: 10.3389/fpubh.2023.1268339] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Accepted: 11/14/2023] [Indexed: 01/23/2024] Open
Abstract
Background There are well-established literatures documenting the associations between mental disorders and unhealthy behaviors such as poor diet quality, sedentary behavior, and cannabis and tobacco use. Few studies have attempted to understand the respective findings in light of each other, however. Objective The purpose of this review was to assemble comparable data for each behavior-disorder association and assess the associations in terms of their overall strength. The review aimed to include a representative, but not exhaustive, range of studies that would allow for explorative comparisons. Methods Eligible studies were identified via Pubmed searches and citation searching, restricted to publications no older than 2015 written in English. To obtain comparable data, only studies that reported findings as odds ratios were included, and risk of bias related to study samples, behavioral measurement disparities, and control variables was assessed via sensitivity analyses. Findings for each disorder were compared on the basis of different measures of central tendency. Results From 3,682 records, 294 studies were included. The review found evidence of associations between each of the four unhealthy behaviors and psychosis, depression, anxiety, bipolar disorder, attention-deficit/hyperactivity disorder (ADHD), and post-traumatic stress disorder (PTSD), while personality disorder was only investigated in relation to cannabis and tobacco use. In overall comparison, the associations were generally of similar strength, and only the association between cannabis use and personality disorder was exceptional in terms of being significantly stronger than its counterparts across disorders and across behaviors. Analyses of bias risk identified some influence from behavioral measurement disparities and lack of adequate statistical control, but findings were generally robust across a range of sensitivity analyses. Conclusion This explorative and comparative review found that poor diet quality, sedentary behavior, and cannabis and tobacco use are about equally strongly associated with a range of different mental disorders. Given the general nature of these associations, we should probably understand them to reflect a general and shared etiology. However, the findings in this review should be regarded as tentative until confirmed by more comprehensive investigations.
Collapse
|
3
|
Substance use, microbiome and psychiatric disorders. Pharmacol Biochem Behav 2022; 219:173432. [PMID: 35905802 DOI: 10.1016/j.pbb.2022.173432] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2021] [Revised: 04/29/2022] [Accepted: 07/20/2022] [Indexed: 11/21/2022]
Abstract
Accumulating evidence from several studies has shown association between substance use, dysregulation of the microbiome and psychiatric disorders such as depression, anxiety, and psychosis. Many of the abused substances such as cocaine and alcohol have been shown to alter immune signaling pathways and cause inflammation in both the periphery and the central nervous system (CNS). In addition, these substances of abuse also alter the composition and function of the gut microbiome which is known to play important roles such as the synthesis of neurotransmitters and metabolites, that affect the CNS homeostasis and consequent behavioral outcomes. The emerging interactions between substance use, microbiome and CNS neurochemical alterations could contribute to the development of psychiatric disorders. This review provides an overview of the associative effects of substance use such as alcohol, cocaine, methamphetamine, nicotine and opioids on the gut microbiome and psychiatric disorders involving anxiety, depression and psychosis. Understanding the relationship between substance use, microbiome and psychiatric disorders will provide insights for potential therapeutic targets, aimed at mitigating these adverse outcomes.
Collapse
|
4
|
Tucker CJ, Bello MS, Weinberger AH, D'Orazio LM, Kirkpatrick MG, Pang RD. Association of depression symptom level with smoking urges, cigarette withdrawal, and smoking reinstatement: A preliminary laboratory study. Drug Alcohol Depend 2022; 232:109267. [PMID: 35042097 DOI: 10.1016/j.drugalcdep.2022.109267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Revised: 12/16/2021] [Accepted: 01/06/2022] [Indexed: 11/26/2022]
Abstract
BACKGROUND Cigarette smoking urges, withdrawal, and smoking reinstatement may be especially relevant to people with elevated depression symptoms who smoke. This laboratory study aimed to assess relations between depression symptom level and smoking urges for reward and relief, cigarette withdrawal, and smoking reinstatement in people who smoke cigarettes daily during acute abstinence and while smoking as usual. METHODS Participants with low (n = 51) or elevated (n = 29) baseline depression symptoms underwent two counterbalanced laboratory sessions (i.e., abstinent, non-abstinent). At each session, they completed subjective measures of smoking urges for reward and relief, and withdrawal. They also completed a laboratory smoking reinstatement task measuring whether they would delay smoking and the number of cigarettes smoked. RESULTS The elevated depression symptom group reported significantly higher withdrawal (p = .01) and smoked more cigarettes than the low depression symptoms group during the smoking reinstatement task self-administration period at the abstinent session (p = .04). Smoking urges for reward and relief were not significantly different by depression symptom group. There were no significant interactions of depression and abstinence with any outcomes. CONCLUSIONS As outcomes were measured at both an abstinent and non-abstinent session, findings identify factors for people with elevated depression symptoms who smoke which may drive smoking behavior and impede smoking cessation efforts. This study provides evidence that people with elevated depression symptoms who smoke may need additional/more pharmacological or behavioral smoking cessation aids targeted at reducing withdrawal and number of cigarettes smoked.
Collapse
Affiliation(s)
- Chyna J Tucker
- Department of Preventive Medicine, University of Southern California, 2001 N. Soto St., Los Angeles, CA 90032, USA; Department of Social Welfare, University of California, Los Angeles, 3250 Public Affairs Building, Los Angeles, CA 90095, USA.
| | - Mariel S Bello
- Department of Psychology, University of Southern California, 3620 McClintock Ave., Los Angeles, CA 90089, USA; Department of Psychiatry & Human Behavior, Warren Alpert Medical School of Brown University, 222 Richmond St., Providence, RI 02903 USA.
| | - Andrea H Weinberger
- Ferkauf Graduate School of Psychology, Yeshiva University and Department of Epidemiology, and Population Health, Albert Einstein College of Medicine, 1165 Morris Park Ave. Rousso Building, Bronx, NY 10461, USA.
| | - Lina M D'Orazio
- Department of Neurology, University of Southern California, 1520 San Pablo St. Los Angeles, CA 90033, USA.
| | - Matthew G Kirkpatrick
- Department of Preventive Medicine, University of Southern California, 2001 N. Soto St., Los Angeles, CA 90032, USA; Department of Psychology, University of Southern California, 3620 McClintock Ave., Los Angeles, CA 90089, USA.
| | - Raina D Pang
- Department of Preventive Medicine, University of Southern California, 2001 N. Soto St., Los Angeles, CA 90032, USA; Department of Psychology, University of Southern California, 3620 McClintock Ave., Los Angeles, CA 90089, USA.
| |
Collapse
|
5
|
Smoking Cessation and Mental Health According to Use of E-cigarettes and Heated Tobacco Products by Korean Adults. Int J Ment Health Addict 2021. [DOI: 10.1007/s11469-021-00698-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
|
6
|
North C, Marti CN, Loukas A. Longitudinal Impact of Depressive Symptoms and Peer Tobacco Use on the Number of Tobacco Products Used by Young Adults. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:11077. [PMID: 34769598 PMCID: PMC8582828 DOI: 10.3390/ijerph182111077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Revised: 10/14/2021] [Accepted: 10/19/2021] [Indexed: 11/17/2022]
Abstract
We examined the role of depressive symptoms in the longitudinal trajectory of the number of tobacco products used across young adulthood, ages 18-30 years, and whether peer tobacco use exacerbated the effects of the depressive symptoms. Participants were 4534 initially 18-25-year-old young adults in the Marketing and Promotions Across Colleges in Texas project (Project M-PACT), which collected data across a 4.5-year period from 2014 to 2019. Growth curve modeling within an accelerated design was used to test study hypotheses. Elevated depressive symptoms were associated with a greater number of tobacco products used concurrently and at least six months later. The number of tobacco-using peers moderated the association between depressive symptoms and the number of tobacco products trajectory. Young adults with elevated depressive symptoms used a greater number of tobacco products but only when they had a greater number of tobacco-using peers. Findings indicate that not all young adults with depressive symptoms use tobacco. Having a greater number of tobacco-using peers may facilitate a context that both models and encourages tobacco use. Therefore, tobacco prevention programs should aim to include peer components, especially for young adults.
Collapse
Affiliation(s)
| | | | - Alexandra Loukas
- Department of Kinesiology & Health Education, University of Texas at Austin, Austin, TX 78712, USA; (C.N.); (C.N.M.)
| |
Collapse
|
7
|
Mantey DS, Clendennen SL, Sumbe A, Wilkinson AV, Harrell MB. Positive Affect and Multiple-tobacco Product Use among Youth: A 3-year Longitudinal Study. Am J Health Behav 2021; 45:849-855. [PMID: 34702432 DOI: 10.5993/ajhb.45.5.5] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Objectives: Multiple-tobacco product (MTP) use is common among adolescent tobacco users. Low positive affect is a risk factor for e-cigarette use and combustible tobacco smoking. In this study, we examine the longitudinal relationship between positive affect and MTP use in a diverse cohort of adolescents in Texas. Methods: We analyzed 6 waves of biennial data (fall 2014-spring 2017) from the Texas Adolescent Tobacco and Marketing Surveillance (TATAMS) system. Participants were 3868 sixth-, eighth-, and tenth-grade students in urban Texas, at enrollment. Multinomial logistic regression models examined the longitudinal relationship between positive affect and categories of MTP use, controlling for sex, race/ethnicity, past 30-day alcohol use, cohort, survey wave, and peer tobacco use. Results: The sample was comprised of 4.6% single-product users, 1.7% dual-users, and 0.7% poly-users. Each unit decrease in positive affect was associated with increased risk for single- (RRR: 1.29; 95% CI: 1.16-1.44), dual- (RRR: 1.35; 95% CI: 1.11-1.64), and poly- (RRR: 1.98; 95% CI: 1.54-2.54) use, relative to non-use. Similarly, each unit decrease in positive affect was also associated with increased risk for poly-tobacco use relative to single- (RRR: 1.53; 95% CI: 1.19-1.97) and dual- (RRR: 1.47; 95% CI: 1.11-1.95) use. Positive affect did not differentiate between single- and dual-use. Conclusion: We observed a gradient relationship between low positive affect and greater number of tobacco products used. Findings reinforce the association between poor mental health and tobacco use during adolescence. Prevention efforts may need to incorporate methods of addressing low positive affect.
Collapse
Affiliation(s)
- Dale S. Mantey
- Dale S. Mantey, NCI Postdoctoral Fellow, Department of Health Promotion and Behavioral Science, Department of Epidemiology, Human Genetics and Environmental Sciences, The University of Texas Health Science Center at Houston (UTHealth)
School of Public Health in Austin, TX, United States
| | - Stephanie L. Clendennen
- Stephanie L. Clendennen, Postdoctoral Fellow, Department of Epidemiology, Human Genetics and Environmental Sciences, The University of Texas Health Science Center at Houston (UTHealth) School of Public Health in Austin,
TX, United States
| | - Aslesha Sumbe
- Aslesha Sumbe, Doctoral Candidate, Department of Epidemiology, Human Genetics and Environmental Sciences, The University of Texas Health Science Center at Houston (UTHealth) School of Public Health in Austin, TX, United States
| | - Anna V. Wilkinson
- Anna V. Wilkinson, Associate Professor, Department of Epidemiology, Human Genetics and Environmental Sciences, The University of Texas Health Science Center at Houston (UTHealth) School of Public Health in Austin, TX, United
States
| | - Melissa B. Harrell
- Melissa B. Harrell, Professor, Department of Epidemiology, Human Genetics and Environmental Sciences, The University of Texas Health Science Center at Houston (UTHealth) School of Public Health in Austin, TX, United States;,
| |
Collapse
|
8
|
Nguyen N, Kapiteni K, Straus ER, Guydish J. Factors associated with dual and polytobacco use among people in residential substance use disorder treatment. Am J Addict 2021; 30:496-504. [PMID: 34427005 PMCID: PMC10039644 DOI: 10.1111/ajad.13206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2021] [Revised: 06/08/2021] [Accepted: 06/22/2021] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Little is known about whether people in substance use disorder (SUD) treatment are at risk for multiple-tobacco use. We examined the factors associated with dual- and polytobacco use among clients in SUD treatment. METHODS A cross-sectional survey was conducted in 2019 among 562 clients (Mage = 39, 74% male) in 20 residential SUD treatment programs in California, USA. The outcomes included single-, dual- (use of two products), and polytobacco use (use of three of more products). Independent variables were nicotine dependence, quitting-related factors, blunt/spliff use, and health-related factors. A multinomial model examined associations between the independent variables and the outcome, controlling for demographics, and time in treatment. RESULTS Overall, 32.6%, 18.9%, and 14.0% of the sample were single-, dual-, and polytobacco users, respectively. Factors associated with increased odds of polytobacco use included greater nicotine dependence (adjusted odds ratio [AOR] = 1.60; 95% CI = 1.19, 2.16), ever using e-cigarettes for quitting (AOR = 4.56; 95% CI = 2.23, 9.34), and past 30-day use of blunt/spliff (AOR = 2.96; 95% CI = 1.48, 5.89). Factors associated with increased odds of dual use were ever using e-cigarettes for quitting (AOR = 3.19; 95% CI = 1.79, 5.66) and reporting more mentally unhealthy days (AOR = 1.05; 95% CI = 1.02, 1.07). CONCLUSION AND SCIENTIFIC SIGNIFICANCE This study extends the literature on tobacco use among people in SUD treatment by revealing the high prevalence of dual- and polytobacco use and the unique characteristics of users. The findings have implications for interventions reducing all types of tobacco use in this understudied population.
Collapse
Affiliation(s)
- Nhung Nguyen
- Center for Tobacco Control Research and Education, University of California San Francisco, CA, USA
- Correspondence: Nhung Nguyen, PhD; Center for Tobacco Control Research and Education, University of California San Francisco, 530 Parnassus Ave, San Francisco, CA, USA 94143. . Phone: 415-502-1488. Fax: 415-476-2265
| | - Kwinoja Kapiteni
- Philip R. Lee Institute for Health Policy Studies, University of California San Francisco, CA, USA
| | - Elana R Straus
- Philip R. Lee Institute for Health Policy Studies, University of California San Francisco, CA, USA
| | - Joseph Guydish
- Philip R. Lee Institute for Health Policy Studies, University of California San Francisco, CA, USA
| |
Collapse
|
9
|
Cwalina SN, Pacek LR, Barrington-Trimis JL, Tackett AP, Pentz MA. Cross-Sectional Associations of Multiple Tobacco Product Use with Depressive and Anxiety Symptoms among Young Adult E-Cigarette Users. Subst Use Misuse 2021; 56:1807-1814. [PMID: 34320919 PMCID: PMC9153521 DOI: 10.1080/10826084.2021.1954026] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
BACKGROUND Tobacco users with mental health conditions are a vulnerable population in tobacco research, yet few studies have evaluated the association of depressive and anxiety symptoms with multiple tobacco product (MTP) use among young adult electronic cigarette (ENDS) users. METHODS Cross-sectional survey data on U.S. young adult past 30-day ENDS users (N = 2348) were collected via Amazon MTurk from May-July 2019. Binary logistic regressions evaluated the association of tobacco use pattern (exclusive ENDS use, ENDS + one other tobacco product [OTP; dual use], ENDS + two or more OTPs [poly-use]) with depressive (PHQ-9) and anxiety (GAD-7) symptoms. Among MTP users (n = 1736), we evaluated the association of ENDS use relative to OTP use and same-day MTP use with depressive and anxiety symptoms. RESULTS The sample included 26% exclusive ENDS, 27% dual, and 47% poly-users. We observed a gradient-relationship for depressive and anxiety symptoms: poly-users had greater odds of depressive and anxiety symptoms compared to dual users (aOR = 1.86 [95%CI:1.50-2.30] and aOR = 1.61 [95%CI:1.30-2.01], respectively), and dual users had greater odds of depressive and anxiety symptoms compared to exclusive ENDS users (aOR = 1.42 [95%CI:1.11-1.81] and aOR = 1.56 [95%CI:1.20-2.02], respectively). MTP users who used ENDS more often than OTPs (vs. less often than OTPs) had greater odds of depressive (aOR = 1.38 [95%CI:1.06-1.80]) and anxiety (aOR = 1.37 [95%CI:1.04-1.79]) symptoms. CONCLUSIONS The majority of young adult past 30-day ENDS users in this sample reported OTP use. Future research on MTP use should distinguish between dual and poly-use. Tobacco prevention efforts for young adults with mental health symptoms are needed.
Collapse
Affiliation(s)
- Sam N Cwalina
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, California, USA
| | - Lauren R Pacek
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, North Carolina, USA
| | - Jessica L Barrington-Trimis
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, California, USA
| | - Alayna P Tackett
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, California, USA
| | - Mary Ann Pentz
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, California, USA
| |
Collapse
|