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.

我们研究了一般成年人群中尼古丁依赖与精神和物质使用障碍的可能性之间的前瞻性关联。参与者来自具有全国代表性的 18 岁或以上美国成年人样本，他们在全国酒精及相关病症流行病学调查（第 1 波，2001-2002 年；第 2 波，2004-2005 年）中接受了相隔 3 年的采访。主要分析仅限于在两轮中接受采访的 32,671 名受访者（13,751 名男性（加权 47.9%）；平均年龄 45 岁 (SD = 0.18)）。我们使用多元回归和倾向评分匹配 (PSM) 来估计与第一波烟草制品使用相关的尼古丁依赖与第二波事件精神疾病之间的独立关联强度。精神疾病通过结构化访谈（酒精使用）进行测量疾病和相关残疾访谈时间表-DSM-IV)。所有分析均针对多种潜在混杂因素进行了调整，包括童年期（物质使用障碍家族史、父母离世、脆弱的家庭环境）、青春期早期（自尊、社会越轨、品行障碍）、青春期后期（教育、人格和精神疾病）疾病）、成年期（离婚、压力性生活事件、社会偏差、生活质量、酒精或其他物质使用障碍史）以及社会人口因素。多元回归分析和 PSM 一致表明尼古丁依赖与任何精神疾病的发生率显着增加相关 (OR = 1.39(95%CI:1.20;1.60))，包括物质使用障碍 (OR = 1.91(95%CI:1.47) ;2.47))和焦虑症(OR = 1.31(95%CI:1.06;1.62))。人口归因风险比例很大，范围为 12。任何精神疾病为 5%(95%CI:8.10;17.0)，任何其他药物使用障碍为 33.3%(95%CI:18.7;48.0)。补充分析还表明，在第一波疾病患者中，尼古丁依赖与精神疾病和药物滥用障碍的持续存在之间存在显着关联。在一般成年人群中，尼古丁依赖与多种精神疾病和药物滥用疾病的可能性增加有关。鉴于其高患病率，这些发现具有重要的公共卫生意义。