Mechanisms underlying the comorbidity of tobacco use in mental health and addictive disorders.
We discuss potential explanations for the high prevalence of tobacco use and tobacco dependence (TD) in people with mental health and addictive (MHA) disorders. The biopsychosocial basis for this comorbidity is presented, integrating evidence from epidemiologic and clinical studies. We also review evidence that suggests a shared vulnerability related to biological, genetic, and environmental factors may be the most parsimonious mechanism to explain the association between TD and MHA disorders. Finally, we review the examples of various MHA disorders that are associated with TD, and suggest avenues for new investigation that could aid in the development of rationale and more effective treatments for tobacco and MHA disorder comorbidities.
Morisano
Dominique
D
Centre for Addiction and Mental Health, Department of Psychiatry, University of Toronto, Toronto, Ontario.
Bacher
Ingrid
I
Audrain-McGovern
Janet
J
George
Tony P
TP
D001921:Brain / Q000187:drug effects; D015897:Comorbidity; D003430:Cross-Sectional Studies; D004200:Diseases in Twins / Q000453:epidemiology / Q000235:genetics / Q000503:physiopathology / Q000523:psychology; D020022:Genetic Predisposition to Disease / Q000235:genetics; D006801:Humans; D001523:Mental Disorders / Q000453:epidemiology* / Q000235:genetics / Q000503:physiopathology / Q000523:psychology*; D018377:Neurotransmitter Agents / Q000378:metabolism; D009538:Nicotine / Q000494:pharmacology; D017981:Receptors, Neurotransmitter / Q000187:drug effects / Q000502:physiology; D012307:Risk Factors; D012907:Smoking / Q000453:epidemiology* / Q000503:physiopathology / Q000523:psychology*; D016540:Smoking Cessation / Q000523:psychology; D019966:Substance-Related Disorders / Q000453:epidemiology* / Q000235:genetics / Q000503:physiopathology / Q000523:psychology*; D016896:Treatment Outcome; D018433:Twin Studies as Topic
D018377:Neurotransmitter Agents; D017981:Receptors, Neurotransmitter; D009538:Nicotine