Cigarette smoking and psychiatric comorbidity in children and adolescents.
OBJECTIVE
To review the current state of knowledge of psychiatric comorbidity in adolescent cigarette smokers.


METHODS
assisted literature search was conducted and seminal articles were cross-referenced for comprehensiveness of the search. For each disorder, a synopsis of knowledge in adults is provided and compared with the knowledge in adolescents.


RESULTS
Psychiatric comorbidity is common in adolescent cigarette smokers, especially disruptive behavior disorders (such as oppositional defiant disorder, conduct disorder, and attention-deficit/hyperactivity disorder), major depressive disorders, and drug and alcohol use disorders. Anxiety disorders are modestly associated with cigarette smoking. Both early onset (<13 years) cigarette smoking and conduct problems seem to be robust markers of increased psychopathology, including substance abuse, later in life. In spite of the high comorbidity, very few adolescents have nicotine dependence diagnosed or receive smoking cessation treatment in child and adolescent psychiatric treatment settings.


CONCLUSIONS
There is increasing evidence for high rates of psychiatric comorbidity in adolescent cigarette smokers. Cigarette smoking in adolescence appears to be a strong marker of future psychopathology. Child and adolescent psychiatry treatment programs may be a good setting for prevention efforts and treatment, which should focus on both nicotine dependence and psychiatric disorders.
Upadhyaya
Himanshu P
HP
Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC 29425, USA.
Deas
Deborah
D
Brady
Kathleen T
KT
Kruesi
Markus
M
D000293:Adolescent; D000328:Adult; D002648:Child; D015897:Comorbidity; D006801:Humans; D001523:Mental Disorders / Q000453:epidemiology* / Q000523:psychology / Q000628:therapy; D012907:Smoking / Q000453:epidemiology*; D016540:Smoking Cessation / Q000379:methods; D000074606:Smoking Prevention