title: The prominence of smoking-related mortality among individuals with alcohol- or drug-use disorders.
abstract: Even though individuals with substance-use disorders have a high prevalence of tobacco smoking, surprisingly little is known about smoking-related mortality in these populations. The current retrospective cohort study aims to address this gap.
  
  
  
  The study sample included cohorts of individuals hospitalised in California between 1990 and 2005 with alcohol- (n = 509 422), cocaine- (n = 35 276), opioid- (n = 53 172), marijuana- (n = 15 995) or methamphetamine-use (n = 36 717) disorders. Death records were linked to inpatient data. Age-, race- and sex-adjusted standardised mortality ratios (SMR) were generated for 19 smoking-related causes of death.
  
  
  
  Smoking-related conditions comprised 49% (79 188/163 191) of total deaths in the alcohol, 40% (1412/3570) in the cocaine, 39% (4285/11 091) in the opioid, 42% (554/1332) in the methamphetamine and 36% (1122/3095) in the marijuana cohorts. The SMRs for all smoking-linked diseases were: alcohol, 3.57 (95% confidence interval [CI] = 3.55 to 3.58); cocaine, 2.40 (95% CI = 2.39 to 2.41); opioid, 4.26 (95% CI = 4.24 to 4.27); marijuana, 3.73 (95% CI = 3.71 to 3.74); and methamphetamine, 2.58 (95% CI = 2.57 to 2.59). The SMRs for almost all of the 19 cause-specific smoking-related outcomes were elevated across cohorts.
  
  
  
  Given the current findings, addressing tobacco smoking among persons with substance-use disorders should be a critical concern, especially given the heavy smoking-related mortality burden and the currently limited attention devoted to smoking in these populations. [Callaghan RC, Gatley JM, Sykes J, Taylor L. The prominence of smoking-related mortality among individuals with alcohol- or drug-use disorders. Drug Alcohol Rev 2018;37:97-105].
authors.affiliation: Northern Medical Program, University of Northern British Columbia, Prince George, Canada.|Human Brain Laboratory, Centre for Addiction and Mental Health, Toronto, Canada.|Dalla Lana School of Public Health, University of Toronto, Toronto, Canada.
authors.forename: Russell C
authors.initials: RC
authors.lastname: Callaghan
authors.affiliation: Northern Medical Program, University of Northern British Columbia, Prince George, Canada.|Human Brain Laboratory, Centre for Addiction and Mental Health, Toronto, Canada.|Dalla Lana School of Public Health, University of Toronto, Toronto, Canada.
authors.forename: Jodi M
authors.initials: JM
authors.lastname: Gatley
authors.affiliation: Department of Biostatistics, Princess Margaret Cancer Centre (University Health Network), Toronto, Canada.
authors.forename: Jenna
authors.initials: J
authors.lastname: Sykes
authors.affiliation: Work, Stress and Health Program, Centre for Addiction and Mental Health, Toronto, Canada.
authors.forename: Lawren
authors.initials: L
authors.lastname: Taylor
mesh_terms: D000328:Adult; D000368:Aged; D000437:Alcoholism / Q000401:mortality*; D002140:California / Q000453:epidemiology; D002423:Cause of Death; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D019966:Substance-Related Disorders / Q000401:mortality*; D000073869:Tobacco Smoking / Q000401:mortality*
keywords: alcohol; illicit drug; mortality; smoking-attributable mortality; tobacco