title: Psychiatric, psychosocial, and physical health correlates of co-occurring cannabis use disorders and nicotine dependence.
abstract: BACKGROUND
  Several gaps in the literature on individuals with co-occurring cannabis and tobacco use exist, including the extent of psychiatric, psychosocial, and physical health problems. We examine these gaps in an epidemiological study, the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC), of a large, nationally representative sample.
  
  
  METHODS
  The sample was drawn from Wave 2 NESARC respondents (N=34,653). Adults with current cannabis use disorders and nicotine dependence (CUD+ND) (n=74), CUD only (n=100), and ND only (n=3424) were compared on psychiatric disorders, psychosocial correlates (e.g., binge drinking; partner violence), and physical health correlates (e.g., medical conditions).
  
  
  RESULTS
  Relative to those with CUD only, respondents with CUD+ND were significantly more likely to meet criteria for bipolar disorder, Clusters A and B personality disorders, and narcissistic personality disorder, and reported engaging in a significantly higher number of antisocial behaviors. Relative to those with ND only, respondents with CUD+ND were significantly more likely to meet criteria for bipolar disorder, anxiety disorders, and paranoid, schizotypal, narcissistic, and borderline personality disorders; were significantly more likely to report driving under the influence of alcohol and being involved in partner violence; and reported engaging in a significantly higher number of antisocial behaviors. CUD+ND was not associated with physical health correlates.
  
  
  CONCLUSIONS
  Poor treatment outcomes for adults with co-occurring cannabis use disorders and nicotine dependence may be explained in part by differences in psychiatric and psychosocial problems.
authors.affiliation: Friends Research Institute, 1040 Park Avenue, Suite 103, Baltimore, MD 21201, USA; Yale University School of Medicine, SATU, One Long Wharf Drive, Box 18, New Haven, CT 06511, USA. Electronic address: epeters@friendsresearch.org.
authors.forename: Erica N
authors.initials: EN
authors.lastname: Peters
authors.affiliation: Friends Research Institute, 1040 Park Avenue, Suite 103, Baltimore, MD 21201, USA.
authors.forename: Robert P
authors.initials: RP
authors.lastname: Schwartz
authors.affiliation: Department of Psychiatry, New York State Psychiatric Institute/Columbia University, 1051 Riverside Drive, Unit 69, New York, NY 10032, USA.
authors.forename: Shuai
authors.initials: S
authors.lastname: Wang
authors.affiliation: Department of Psychology, University of Maryland, 300 Campus Drive, College Park, MD 20742, USA.
authors.forename: Kevin E
authors.initials: KE
authors.lastname: O'Grady
authors.affiliation: Department of Psychiatry, New York State Psychiatric Institute/Columbia University, 1051 Riverside Drive, Unit 69, New York, NY 10032, USA.
authors.forename: Carlos
authors.initials: C
authors.lastname: Blanco
mesh_terms: D000293:Adolescent; D015897:Comorbidity; D005260:Female; D006304:Health Status; D006306:Health Surveys / Q000639:trends; D006801:Humans; D008297:Male; D002189:Marijuana Abuse / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology*; D001523:Mental Disorders / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology*; D008603:Mental Health / Q000639:trends; D011584:Psychology; D012309:Risk-Taking; D014029:Tobacco Use Disorder / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology*; D055815:Young Adult
keywords: Cannabis; Co-occurring disorders; Marijuana; Nicotine dependence; Smoking; Tobacco