A new study investigated the relationship between mental health status and tobacco use among young adults. In fall 2010, a sample of first-year U.S. college students completed an initial screener survey (N = 10,528) about their college experiences and substance use. Of these, a cohort of 3,146 students completed the baseline survey for the present study. This group oversampled smokeless tobacco ever users, current smokers, and males. The cohort was resurveyed each semester until fall 2013 (wave 6); 2,500 participants completed the wave 6 survey, for a retention rate of 79.5%. At wave 6, participants reported whether they had received one or more mental health diagnoses in the past six months, past 30-day perceived stress levels, past-week depressive symptoms, and ever tobacco use. Tobacco use was defined as any use of 15 types of tobacco products, including cigars, cigarettes, e-cigarettes, waterpipes, or smokeless tobacco. Participants who endorsed tobacco use indicated the interval in which they had used each product (e.g., past week, past month). Participants were also asked to report their sociodemographic characteristics. The analytic sample consisted of the 2,370 cohort members who reported tobacco use. The authors used logistic regression models predicting tobacco use that were fit for each product and mental health predictor separately. Multiple imputations by chained equations were used to handle any missing covariate data. Results indicated 27.3% of participants reported past-month tobacco use and the three most commonly used products were cigarettes, waterpipe, and e-cigarettes. 10.5% (n = 249) of the analytic sample reported a mental health diagnosis, most frequently depression, ADHD, and anxiety. Of these 249 students, 18.5% reported having two or more diagnoses. Participants who reported a past-six month mental health diagnosis had greater odds of reporting past 30-day cigarette use (AOR = 1.55, CI = 1.01, 2.27), controlling for age, sex, race, ethnicity, and mother’s education. The authors observed a dose-response relationship, in which participants who reported more than one mental health diagnosis had greater odds for reporting cigarette use (AOD = 3.16, CI = 1.58, 6.33) and any tobacco use (AOD = 2.76, CI = 1.14, 6.71) than their peers with no mental health diagnoses. Higher perceived stress score was associated with increased odds for cigarette, waterpipe, e-cigarette, and any tobacco use, controlling for demographics and past 30-day use. Higher depression symptoms were associated with increased odds of cigarette, e-cigarette, or any tobacco use, controlling for the same covariates. A limitation of this study is its reliance on self-reported tobacco use, mental health diagnoses, and mental health symptoms.
Take away: In this study, self-reported mental health diagnoses received in the past six months, past-month perceived stress levels, and past-week depressive symptoms were positively associated with odds of using at least one type of tobacco product.