title: Cigarette smoking and psychiatric comorbidity in children and adolescents.
abstract: 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.
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC 29425, USA.
authors.forename: Himanshu P
authors.initials: HP
authors.lastname: Upadhyaya
authors.forename: Deborah
authors.initials: D
authors.lastname: Deas
authors.forename: Kathleen T
authors.initials: KT
authors.lastname: Brady
authors.forename: Markus
authors.initials: M
authors.lastname: Kruesi
mesh_terms: 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