The co-occurrence of nicotine and other substance use and addiction among youth and adults in the United States: implications for research, practice, and policy

Am J Drug Alcohol Abuse. 2017 Mar;43(2):132-145. doi: 10.1080/00952990.2016.1193511. Epub 2016 Aug 5.

Abstract

Background: The increasing popularity of non-cigarette nicotine products, especially among youth, highlights the need for greater attention to their potential risks, including nicotine addiction and other substance use and addiction.

Objectives: To examine the extent to which nicotine product use co-occurs with other substance use and addiction among youth and adults, describe the demographic groups and types of nicotine products associated with an increased risk of such co-occurrence, and discuss implications for research, prevention, clinical practice, and policy.

Methods: Analyzing 2014 data from two nationally representative US surveys, the National Survey on Drug Use and Health (NSDUH) and the Monitoring the Future (MTF) study, we examined the co-occurrence between nicotine product use and alcohol and other drug use and addiction.

Results: Individuals of all ages who reported using nicotine products of any kind were significantly more likely than nonusers to report alcohol, marijuana, other drug, and poly-substance use and to meet diagnostic criteria for a substance-use disorder. Users of multiple nicotine products generally were the most likely to engage in alcohol and other drug use and to be addicted to these other substances.

Conclusions: The substantial co-occurrence of all forms of nicotine use and other substance use and addiction underscores the need to control the growing use of non-cigarette nicotine products among youth and to incorporate all forms of nicotine product use into substance use and addiction research, prevention, clinical practice, and policy efforts.

Keywords: Cigarettes; co-occurrence; electronic cigarettes; nicotine; substance use disorders; tobacco.

MeSH terms

  • Adolescent
  • Adult
  • Behavior, Addictive / epidemiology*
  • Case-Control Studies
  • Child
  • Comorbidity
  • Female
  • Health Policy / trends
  • Health Surveys
  • Humans
  • Male
  • Research / trends
  • Substance-Related Disorders / epidemiology*
  • Tobacco Products / statistics & numerical data
  • Tobacco Use Disorder / epidemiology*
  • United States / epidemiology
  • Young Adult