title: Psychiatric correlates of snuff and chewing tobacco use.
abstract: Compared to the association between cigarette smoking and psychiatric disorders, relatively little is known about the relationship between smokeless tobacco use and psychiatric disorders. To identify the psychiatric correlates of smokeless tobacco use, the analysis used a national representative sample from the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC) wave 1. Smokeless tobacco use was classified as exclusive snuff use, exclusive chewing tobacco, and dual use of both snuff and chewing tobacco at some time in the smokeless tobacco user's life. Lifetime psychiatric disorders were obtained via structured diagnostic interviews. The results show that the prevalence of lifetime exclusive snuff use, exclusive chewing tobacco, and dual use of both snuff and chewing tobacco was 2.16%, 2.52%, and 2.79%, respectively. After controlling for sociodemographic variables and cigarette smoking, the odds of exclusive chewing tobacco in persons with panic disorder and specific phobia were 1.53 and 1.41 times the odds in persons without those disorders, respectively. The odds of exclusive snuff use, exclusive chewing tobacco, and dual use of both products for individuals with alcohol use disorder were 1.97, 2.01, and 2.99 times the odds for those without alcohol use disorder, respectively. Respondents with cannabis use disorder were 1.44 times more likely to use snuff exclusively than those without cannabis use disorder. Respondents with inhalant/solvent use disorder were associated with 3.33 times the odds of exclusive chewing tobacco. In conclusion, this study highlights the specific links of anxiety disorder, alcohol, cannabis, and inhalant/solvent use disorders with different types of smokeless tobacco use.
authors.affiliation: Department of Biostatistics, College for Public Health and Social Justice, Saint Louis University, St. Louis, Missouri, United States of America.
authors.forename: Qiang
authors.initials: Q
authors.lastname: Fu
authors.affiliation: School of Social Work, College for Public Health and Social Justice, Saint Louis University, St. Louis, Missouri, United States of America.
authors.forename: Michael G
authors.initials: MG
authors.lastname: Vaughn
authors.affiliation: Department of Psychiatry and Behavioral Science, Duke University Medical Center, Durham, North Carolina, United States of America.
authors.forename: Li-Tzy
authors.initials: LT
authors.lastname: Wu
authors.affiliation: Department of Psychiatry, School of Medicine, Washington University in St. Louis, St Louis, Missouri, United States of America.
authors.forename: Andrew C
authors.initials: AC
authors.lastname: Heath
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D016001:Confidence Intervals; D003710:Demography; D005260:Female; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology; D008875:Middle Aged; D016017:Odds Ratio; D015995:Prevalence; D012907:Smoking / Q000453:epidemiology / Q000523:psychology; D064424:Tobacco Use / Q000453:epidemiology / Q000523:psychology*; D014030:Tobacco, Smokeless