title: Nicotine dependence and psychiatric and substance use disorder comorbidities among American Indians/Alaska Natives: findings from the National Epidemiologic Survey on Alcohol and Related Conditions.
abstract: BACKGROUND
  American Indians and Alaska Natives (AI/ANs) have high rates of tobacco use compared to the general population. AI/ANs also have elevated rates of psychiatric and substance use disorders associated with nicotine dependence. However, very few studies have examined the comorbidity between nicotine dependence and psychiatric and substance use disorders within this population.
  
  
  METHODS
  This study analyzes the comorbidity of lifetime nicotine dependence with both current and lifetime psychiatric disorders and substance use disorders in a nationally representative sample of 701 AI/AN women and men.
  
  
  RESULTS
  Using 95% confidence interval testing, lifetime nicotine dependence (29.5%) was associated with all main diagnostic categories (any mood disorder, any anxiety disorder, any personality disorder, any alcohol use disorder, and any drug use disorder) both at the lifetime level and current (12-month) level. Of the lifetime disorders, the strongest associations were with psychosis and drug dependence. For (current) 12-month disorders, the strongest associations were with alcohol dependence and drug dependence. Differences were noted between genders regarding personality disorders.
  
  
  CONCLUSIONS
  Culturally appropriate tobacco screening, prevention, and treatment curricula for adult AI/ANs with dual diagnoses are recommended. Understanding historically based factors that may contribute to psychiatric illness and substance use disorders may assist in more effective nicotine treatments for AI/ANs.
authors.affiliation: University of California Los Angeles (UCLA) Gambling Studies Program, UCLA Department of Psychiatry and Biobehavioral Sciences, 760 Westwood Plaza, Suite 38-153, Los Angeles, CA 90095-1759, USA. Electronic address: Jacquelene@post.harvard.edu.
authors.forename: Jacquelene F
authors.initials: JF
authors.lastname: Moghaddam
authors.affiliation: University of California Los Angeles Integrated Substance Abuse Programs, 11075 Santa, Monica Boulevard, Suite 100, Los Angeles, CA 90025, USA.
authors.forename: Daniel L
authors.initials: DL
authors.lastname: Dickerson
authors.affiliation: Minneapolis VA Health Care System. One Veterans Drive, Minneapolis, MN 55417, USA; University of Minnesota Medical School. One Veterans Drive, Minneapolis, MN 55417, USA.
authors.forename: Gihyun
authors.initials: G
authors.lastname: Yoon
authors.affiliation: Minneapolis VA Health Care System. One Veterans Drive, Minneapolis, MN 55417, USA; University of Minnesota Medical School. One Veterans Drive, Minneapolis, MN 55417, USA.
authors.forename: Joseph
authors.initials: J
authors.lastname: Westermeyer
mesh_terms: D000293:Adolescent; D000328:Adult; D000413:Alaska / Q000208:ethnology; D019973:Alcohol-Related Disorders / Q000175:diagnosis / Q000208:ethnology / Q000523:psychology; D001008:Anxiety Disorders / Q000175:diagnosis / Q000208:ethnology / Q000523:psychology; D015897:Comorbidity; D017831:Diagnosis, Dual (Psychiatry); D055030:Drug Users / Q000523:psychology; D005260:Female; D006306:Health Surveys / Q000379:methods; D006801:Humans; D007198:Indians, North American / Q000208:ethnology* / Q000523:psychology*; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis / Q000208:ethnology* / Q000523:psychology; D008875:Middle Aged; D019964:Mood Disorders / Q000175:diagnosis / Q000208:ethnology / Q000523:psychology; D019966:Substance-Related Disorders / Q000175:diagnosis / Q000208:ethnology / Q000523:psychology; D014029:Tobacco Use Disorder / Q000175:diagnosis / Q000208:ethnology* / Q000523:psychology*
keywords: Alaska Native; American Indian; Comorbidity; Nicotine dependence; Smoking; Substance abuse