title: Associations between a History of Traumatic Brain Injuries and Current Cigarette Smoking, Substance Use, and Elevated Psychological Distress in a Population Sample of Canadian Adults.
abstract: This study describes the prevalence of reported history of traumatic brain injury (TBI) and its association with reports of current substance use, cigarette smoking, and psychological distress among Canadian adults in a population sample. A cross-sectional sample of 1999 Ontario adults 18-93 years of age were surveyed by telephone in 2011 as part of the Center for Addiction and Mental Health's ongoing representative survey of adult mental health and substance use in Ontario, Canada. Loss of consciousness for at least 5 min or at least one overnight hospitalization resulting from symptoms associated with the TBI injury represented minimum criteria for TBI. An estimated 16.8% (95% confidence interval, 14.8, 19.0) of adults reported a TBI in their lifetime. Men had higher prevalence of TBI than women. Adults who reported a history of TBI had higher odds of reported past-year daily smoking (adjusted odds ratio [AOR] = 2.15), using cannabis (AOR = 2.80) and nonmedical opioids (AOR = 2.90), as well as screened significantly for recent elevated psychological distress (AOR = 1.97) in the past few weeks, compared to adults without a history of TBI. Co-occurrence of a history of TBI with current elevated psychological distress and substance use warrants vigilance among medical practitioners to assess the possibility of a history of TBI during reviews of the history leading to the occurrence of these conditions.
authors.affiliation: 1 Injury Prevention Research Office, St. Michael's Hospital , Toronto, Ontario, Canada .|4 Division of Neurosurgery, University of Toronto , Toronto, Ontario, Canada .
authors.forename: Gabriela
authors.initials: G
authors.lastname: Ilie
authors.affiliation: 2 Social and Epidemiological Research, Center for Addiction and Mental Health , Toronto, Ontario, Canada .
authors.forename: Edward M
authors.initials: EM
authors.lastname: Adlaf
authors.affiliation: 2 Social and Epidemiological Research, Center for Addiction and Mental Health , Toronto, Ontario, Canada .
authors.forename: Robert E
authors.initials: RE
authors.lastname: Mann
authors.affiliation: 2 Social and Epidemiological Research, Center for Addiction and Mental Health , Toronto, Ontario, Canada .
authors.forename: Anca
authors.initials: A
authors.lastname: Ialomiteanu
authors.affiliation: 2 Social and Epidemiological Research, Center for Addiction and Mental Health , Toronto, Ontario, Canada .
authors.forename: Hayley
authors.initials: H
authors.lastname: Hamilton
authors.affiliation: 2 Social and Epidemiological Research, Center for Addiction and Mental Health , Toronto, Ontario, Canada .
authors.forename: Jürgen
authors.initials: J
authors.lastname: Rehm
authors.affiliation: 3 Department of Community Health and Epidemiology, Dalhousie University , Halifax, Nova Scotia, Canada .
authors.forename: Mark
authors.initials: M
authors.lastname: Asbridge
authors.affiliation: 1 Injury Prevention Research Office, St. Michael's Hospital , Toronto, Ontario, Canada .|4 Division of Neurosurgery, University of Toronto , Toronto, Ontario, Canada .
authors.forename: Michael D
authors.initials: MD
authors.lastname: Cusimano
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001930:Brain Injuries / Q000453:epidemiology* / Q000523:psychology; D002170:Canada / Q000453:epidemiology; D015897:Comorbidity; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012907:Smoking / Q000453:epidemiology*; D013315:Stress, Psychological / Q000453:epidemiology* / Q000523:psychology; D019966:Substance-Related Disorders / Q000453:epidemiology* / Q000523:psychology; D055815:Young Adult
keywords: adults; psychological distress; substance use; traumatic brain injury