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Nicotine dependence and incident psychiatric disorders: prospective evidence from US national study

Molecular Psychiatry (2024)Cite this article

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Abstract

We examined the prospective associations between nicotine dependence and the likelihood of psychiatric and substance use disorders in the general adult population. Participants came from a nationally representative sample of US adults aged 18 years or older, who were interviewed 3 years apart in the National Epidemiologic Survey on Alcohol and Related Conditions (Wave 1, 2001–2002; Wave 2, 2004–2005). The primary analyses were limited to 32,671 respondents (13,751 male (47.9% weighted); mean age of 45 years (SD = 0.18)) who were interviewed in both waves. We used multiple regression and propensity score matching (PSM) to estimate the strength of independent associations between nicotine dependence related to the use of tobacco products at Wave 1 and incident psychiatric disorders at Wave 2. Psychiatric disorders were measured with a structured interview (Alcohol Use Disorder and Associated Disabilities Interview Schedule-DSM-IV). All analyses adjusted for multiple potential confounders, including childhood (family history of substance use disorders, parental loss, vulnerable family environment), early-adolescence (self-esteem, social deviance, conduct disorder), late-adolescence (education, personality and psychiatric disorders), adulthood (divorce, stressful life events, social deviance, quality of life, history of alcohol or other substance use disorder), and sociodemographic factors. Multiple regression analysis and PSM converged in indicating that nicotine dependence was associated with significantly increased incidence of any psychiatric disorder (OR = 1.39(95%CI:1.20;1.60)), including substance use disorders (OR = 1.91(95%CI:1.47;2.47)), and anxiety disorders (OR = 1.31(95%CI:1.06;1.62)). Population Attributable Risk Proportions were substantial, ranging from 12.5%(95%CI:8.10;17.0) for any psychiatric disorder to 33.3%(95%CI:18.7;48.0) for any other drug use disorder. Supplementary analyses also indicated significant associations between nicotine dependence and persistence of psychiatric and substance use disorders among patients having a disorder at Wave 1. In the general adult population, nicotine dependence is associated with an increased likelihood for several psychiatric and substance use disorders. Given its high prevalence, these findings have important public health implications.

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Data availability

The National Epidemiologic Survey on Alcohol and Related Conditions was sponsored by the National Institute on Alcohol Abuse and Alcoholism and funded, in part, by the Intramural Program, NIAAA, National Institutes of Health. The original dataset for the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC) is available upon request from the National Institute on Alcohol Abuse and Alcoholism (http://www.niaaa.nih.gov).

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Funding

The National Epidemiologic Survey on Alcohol and Related Conditions was sponsored by the National Institute on Alcohol Abuse and Alcoholism and funded, in part, by the Intramural Program, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health. The funding sources had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication.

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Authors and Affiliations

  1. Department of Psychiatry and Addictology, AP-HP.Centre-Université Paris Cité, Paris, France

    Guillaume Airagnes, Marina Sánchez-Rico, Amélia Deguilhem, Charles Ouazana Vedrines, Cédric Lemogne, Frédéric Limosin & Nicolas Hoertel

  2. Université Paris Cité, Faculté de Santé, UFR de Médecine, Paris, France

    Guillaume Airagnes, Charles Ouazana Vedrines, Cédric Lemogne, Frédéric Limosin & Nicolas Hoertel

  3. INSERM UMS011, Population-based Epidemiological Cohorts, Villejuif, France

    Guillaume Airagnes

  4. Division of Epidemiology, Services, and Prevention Research, National Institute on Drug Abuse, Bethesda, MD, USA

    Carlos Blanco

  5. Department of Psychiatry, Columbia University Irving Medical Center/New York State Psychiatric Institute, New York, NY, USA

    Mark Olfson

  6. Université Paris Cité, and Université Sorbonne Paris Nord, INSERM, INRAE, Centre for Research in Epidemiology and StatisticS (CRESS), Paris, France

    Charles Ouazana Vedrines & Cédric Lemogne

  7. INSERM UMR_1266, Institut de Psychiatrie et Neuroscience de Paris, Paris, France

    Frédéric Limosin & Nicolas Hoertel

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  1. Guillaume Airagnes
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  2. Marina Sánchez-Rico
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  3. Amélia Deguilhem
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  4. Carlos Blanco
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  6. Charles Ouazana Vedrines
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Contributions

Study protocol: GA, FL, NH. Conceptualization: GA, MSR, AD, FL, NH. Data curation: MSR, CB, MO, NH. Formal analysis: MSR, NH. Methodology: GA, MSR, AD, CB, MO, NH. Writing—original draft: GA. Writing—review & editing: GA, MSR, AD, CB, MO, COV, CL, FL, NH.

Corresponding author

Correspondence to Guillaume Airagnes.

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Competing interests

GA received speaker and/or consulting fees from Pfizer, Pierre Fabre, Lundbeck, and Zentiva, outside the submitted work. Other authors have no conflict of interest to declare.

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All methods were performed in accordance with the relevant guidelines and regulations. All procedures received full human subjects review and approval from the US Census Bureau and US Office of Management and Budget. All participants provided written informed consent.

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Airagnes, G., Sánchez-Rico, M., Deguilhem, A. et al. Nicotine dependence and incident psychiatric disorders: prospective evidence from US national study. Mol Psychiatry (2024). https://doi.org/10.1038/s41380-024-02748-6

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