Predictors of persistent nicotine dependence among adults in the United States

Abstract

Background Evidence suggests that nicotine dependence is the key barrier to successful smoking cessation. No previous study has documented predictors of persistent nicotine dependence among adults in the community. The goal of this study is to prospectively identify predictors of continued nicotine dependence over a 3-year period among adults. Methods Data were drawn from Waves I and II of the National Epidemiologic Survey of Alcohol and Related Conditions (NESARC), a nationally representative sample of 34,653 adults in the United States. Logistic regression analyses were used to estimate the odds of persistent nicotine dependence at Wave 2 given the presence of various sociodemographic and psychiatric predictors at Wave 1. Results Mood, anxiety, personality and illicit substance use disorders were associated with significantly increased risk of persistent nicotine dependence. The strength of these relationships was attenuated slightly after adjusting for demographic differences, but remained statistically significant. Persistent nicotine dependence was more common among unmarried, younger females with lower income levels and lower educational attainment. Conclusions To our knowledge, this study is the first to prospectively identify predictors of persistent nicotine dependence among adults. Our results suggest that the incorporation of mental health treatment into alternative smoking cessation approaches may help to increase the effectiveness of these programs and that a greater focus of these services on vulnerable segments of the population is needed in order to reduce continued disparities in smoking in the general population.

Changes in Prevalence of Depression and Anxiety Following Smoking Cessation: Results From an International Cohort Study (ATTEMPT)

“…In addition, as shown previously, greater nicotine dependence was associated with anxiety (Goodwin et al 2011), and improvement in general health was associated with better mental health (Wise & Taylor, 1990;Sherbourne et al 1996;Patten, 2001;Ruo et al 2003;Evans et al 2005;Beard et al 2007;Janney et al 2008;Carek et al 2011).…”

Depression and cigarette smoking behavior: A critical review of population-based studies

“…Data from the majority of these studies lend consistent support for a strong relationship between nicotine dependence and depression (6,27,29,(34)(35)(36)48,(55)(56)(57). Overall, the findings suggest that adolescents and adults with past-year MDD, dysthymia, or depressive symptoms reported higher rates of current (6,27,(34)(35)(36)48,55,57) and lifetime (27) nicotine dependence than those without MDD, dysthymia, or depressive symptoms. In contrast, one study found no significant differences in the rate of lifetime nicotine dependence between those with and without an active diagnosis of dysthymia; however, significant associations between active MDD, preexisting MDD, and preexisting dysthymia and lifetime nicotine dependence emerged (29).…”

Nicotine Reduction: Strategic Research Plan

“…Mental illness is also predictive of persistent smoking (Goodwin, Pagura, Spiwak, Lemeshow, & Sareen, 2011), suggesting greater difficulty with RNC cigarettes in this population. Despite barriers to quitting, a significant number of smokers with comorbid disorders report wanting to quit (Weinberger, Desai, & McKee, 2010).…”