Smoking, posttraumatic stress disorder, and alcohol use disorders in a nationally representative sample of Australian men and women. (1st November 2015)

• Record Type: Journal Article
• Authors: Forbes, Miriam K.; Flanagan, Julianne C.; Barrett, Emma L.; Crome, Erica; Baillie, Andrew J.; Mills, Katherine L.; Teesson, Maree
• Is Part Of: Drug and alcohol dependence. Volume 156(2015)
• Page Start: 176
• Page End: 183
• Publication Date: 2015-11-01
• Subjects: PTSD -- Alcohol use disorders -- Smoking -- Comorbidity; Drug abuse -- Periodicals; Alcoholism -- Periodicals; 616.86
• DOI: 10.1016/j.drugalcdep.2015.09.007
• Languages: English
• ISSNs: 0376-8716

Abstract

Highlights: Daily smoking, PTSD, and alcohol use disorders (AUDs) had high rates of comorbidity. Trauma exposure tended to precede daily smoking and problems with alcohol. Smoking, PTSD, and AUDs had additive negative effects on mental and physical health. Comorbid smoking, PTSD, and AUDs are associated with impairment and poor wellbeing. Abstract: Background: Posttraumatic stress disorder (PTSD) and alcohol use disorders (AUDs) often co-occur with smoking and tobacco use disorders. Each of these disorders is known to have negative health consequences and impairment independently, but little is known about the impact of their co-occurrence. The aim of the present study is to examine the prevalence, correlates, order of onset, and impact of co-occurring daily smoking, PTSD, and AUDs. Method: The 2007 Australian National Survey of Mental Health and Wellbeing (2007 NSMHWB) was a nationally representative survey of 8841 Australians. The survey assessed for 12-month DSM-IV mental disorders; the age respondents first started smoking daily, experienced a traumatic event, or developed problems with alcohol; and self-reported mental and physical health and impairment. Results: There were systematic patterns of co-occurrence between daily smoking, PTSD, and AUDs. Daily smoking and problems with alcohol use tended to develop after first trauma exposure, which is broadly consistent with the self-medication hypothesis. Daily smoking, PTSD, and AUDs were also associated with additive negative effects on mental and physical health and functioning, after controlling for demographics. Conclusions: Smoking, PTSD, and AUDs commonly co-occur in this nationally representative sample of Australian men and women, and this comorbidity was associated with greater severity of mental and physical health problems and impairment in several areas of functioning. This study highlights the importance of identifying and eliminating these patterns of co-occurrence, potentially through integrated interventions.