No information is available on the co-occurrence of DSM-IV nicotine dependence and Axis I and II psychiatric disorders
in the US population.
To present national data on the co-occurrence of current DSM-IV nicotine dependence and other psychiatric disorders by sex and
to estimate the burden of all US tobacco consumption carried by nicotine-dependent
and psychiatrically ill individuals.
The United States.
Household and group-quarters adults (N = 43 093).
Main Outcome Measures
Prevalence and comorbidity of current nicotine dependence and Axis I
and II disorders and the percentage of cigarettes consumed in the United States
among psychiatrically vulnerable subgroups.
Among US adults, 12.8% (95% confidence interval, 12.0-13.6) were nicotine
dependent. Associations between nicotine dependence and specific Axis I and
II disorders were all strong and statistically significant (P<.05) in the total population and among men and women. Nicotine-dependent
individuals made up only 12.8% (95% confidence interval, 12.0-13.6) of the
population yet consumed 57.5% of all cigarettes smoked in the United States.
Nicotine-dependent individuals with a comorbid psychiatric disorder made up
7.1% (95% confidence interval, 6.6-7.6) of the population yet consumed 34.2%
of all cigarettes smoked in the United States.
Nicotine-dependent and psychiatrically ill individuals consume about
70% of all cigarettes smoked in the United States. The results of this study
highlight the importance of focusing smoking cessation efforts on individuals
who are nicotine dependent, individuals who have psychiatric disorders, and
individuals who have comorbid nicotine dependence and other psychiatric disorders.
Further, awareness of industry segmentation strategies can improve smoking
cessation efforts of clinicians and other health professionals among all smokers
and especially among the most vulnerable.