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“[T]he need for early and specific tobacco product use screening, as well as screening across the spectrum of mental health problems, as tools to prevent tobacco product use onset is apparent,” wrote Wilson Compton, M.D., M.P.E., deputy director of the National Institute on Drug Abuse, and colleagues. “Providing incentives to providers to link these two screening mechanisms could increase the overall integration of these services in clinical practice.”
For the study, Compton and colleagues relied on data obtained from youth and young adults who were participants in the longitudinal Population Assessment of Tobacco and Health (PATH) Study. Specifically, the authors analyzed data from 9,067 youth (12 to 17 years) and 1,466 young adults (18 to 24 years) who reported having never used tobacco products at the beginning of the study (Wave 1).
At Wave 1, the study participants completed the Global Appraisal of Individual Needs-Short Screener, which assesses internalizing and externalizing problems, and answered questions about drug and alcohol use. At Wave 2 (approximately one year later), the participants were again asked about their use of tobacco products (including cigarettes, electronic nicotine delivery systems, traditional cigars, cigarillos, filtered cigars, pipe, hookah, smokeless tobacco, snus pouches, bidis, kreteks, and dissolvable tobacco) over the past 12 months.
After adjusting for sociodemographics, alcohol or drug use, and externalizing problems, youth and young adults with high severity internalizing problems were found to be 1.5 times more likely to begin use of any tobacco product compared with those with no/low/moderate severity internalizing problems. Youth and young adults with high severity externalizing problems were 1.3 times more likely to begin use of any tobacco product compared with those with no/low/moderate severity externalizing symptoms.
Additional analysis revealed that youth and young adults with high severity internalizing problems were about 1.8 times more likely to report new use of multiple tobacco products. The “findings of a dose-response relationship between internalizing problems and onset of exclusive and poly-tobacco use, respectively, suggest that youth and young adults with internalizing problems were not only more likely to begin using tobacco products compared to those without internalizing problems, but were also more likely to begin using with multiple tobacco products,” the authors wrote.
They concluded, “This study demonstrates that mental health problems predict the onset of tobacco use among youth and young adults in a nationally representative sample, and across a wide range of tobacco products beyond cigarettes. … In addition to screening for tobacco product use, health care providers should screen for a range of mental health problems as a predictor of tobacco use.”
For related information, see the Psychiatric News article “FDA’s ‘Real Cost’ Campaign Cuts Cigarette Smoking by Teens.”
(Image: iStock/prudkov)
