Alcohol and tobacco use disorders in a general population: short-term and long-term associations from the St. Louis epidemiological catchment area study.

Abstract

Although research using clinical and convenience samples has shown alcohol use disorders (AUD) to be highly comorbid with tobacco dependence (TD), little work has examined this association prospectively using population-based data. The AUD-TD association was prospectively examined using data from the St. Louis Epidemiological Catchment Area (ECA) Study and its 1-year follow-up as well as from a 16-year follow-up on a subsample of ECA data. Respondents were 3004 (2564, 85%, at Wave 2) participants in the St. Louis household ECA sample, including 444 participants at Year 16 follow-up. At baseline, the sample was predominately White (58%; 38% Black), female (60%), and 44.3 years. Past-year AUD and TD were diagnosed at all waves according to DSM-III criteria. AUDs and TDs were cross-sectionally associated at Years 1, 2, and 16. Controlling for demographics, Year 1 TD prospectively predicted Year 2 AUD, and Year 1 AUD prospectively predicted Year 16 TD. We found evidence for prediction of onset and persistence of both AUD and TD at short-term but not long-term follow-up. Prospective findings were reduced and no longer reached significance when concurrent diagnoses at follow-up were included in the regression models. We observed short-term and long-term associations between AUD and TD. These associations were mediated through concurrent diagnoses with the other substance use disorder.