Table 2.
Characteristics of studies focused on Mental Health Conditions/Medical Comorbidities.
| First author (year)1 | Sample description | Data years | N (% female)2 | Study description & main findings | Tobacco product | Scientific domains |
|---|---|---|---|---|---|---|
| Higgins et al. (2016) | U.S. National Sample | 2011–2013 | 114,426 (19%) | Three years of cross-sectional NSDUH3 survey data were pooled to examine risk factors for current smoking. Age, gender, race/ethnicity, educational attainment, poverty, alcohol use disorders, substance use disorders and mental illness were all independently associated with smoking; effects of risk-factor combinations were typically summative. | Cigarettes | Behavior |
| Nemeth et al. (2018) | Rural women in Ohio | 2012–2013 | 401 (100%) | Cross-sectional data were used to examine risk factors for cigarette use. Younger age, greater depressive symptom severity, greater normative acceptance of smoking and greater neighborhood cohesion increased risks for current smoking. | Cigarettes | Addiction, Behavior |
| White et al. (2016) | U.S. National Sample | 2012 | 37,869 (51.9%) | Cross-sectional NSDUH survey data were used to examine risk factors for current cigarette and SLT4 use. Past year diagnosis of major depressive disorder, along with other demographic predictors, contributed to odds of smoking but not SLT use. Dependence on alcohol, marijuana, heroin, and cocaine were associated with cigarette use; all except cocaine dependence were also associated with SLT use. | Cigarettes, SLT | Behavior |
| Stanton et al. (2016) | U.S. National Sample | 2005–2013 | 335,080 (51.9%) | Nine years of cross-sectional NSDUH survey data were pooled to examine whether chronic medical and mental health conditions were associated with current use of cigarettes, cigars, pipes, or SLT. Cigarette use was higher and stable over time among those with comorbidities, mental health and substance use disorders, whereas use declined among those without comorbidities. Cigar and pipe use were higher among those with comorbidities and were stable over time; SLT increased over time in all. | Cigarettes Cigars, SLT, Pipes | Behavior |
| Hefner et al. (2016) | VA patients in Connecticut | 2015 | 188 (10%) | A convenience sample of smokers was used to compare characteristics of ENDS5 users and non-users and perceptions of ENDS. ENDS users (30.9% of sample) were more likely to have a mental health disorder and less likely to have an alcohol use disorder than non-users. | ENDS | Addiction, Behavior |
| Spears et al. (2016) | U.S. National Sample | 2015 | 6051 (51.4%) | Cross-sectional survey of ENDS use in people with and without lifetime mental health conditions (MHCs). People with MHCs, particularly former smokers, were more likely to use ENDS, and former smokers with MHCs are more likely to report having used ENDS during smoking quit attempts than those without a MHC. | Cigarettes, ENDS | Behavior |
| Miller et al. (2017) | U.S. National Sample | 2013–2014 | 32,320 (51.9%) | Data from Wave 1 of the PATH6 survey were used to examine relationships between self-perceived mental health and tobacco use. Poorer self-perceived mental health was associated with increased cigarette, ENDS, cigarillo, filtered cigar and SLT use, but not increased traditional cigar use; motives for use were similar across mental health status conditions. | Cigarettes, ENDS, Cigars, Cigarillo s, SLT | Behavior |
| Higgins et al. (2017a) | U.S. National Sample | 2011–2013 | 114,426 (NR)7 | Three years of cross-sectional NSDUH survey data were pooled to examine risk factors for smoking higher-vs. lower-nicotine yield cigarettes. Age, gender, race/ethnicity, educational attainment, poverty, substance use disorders and mental illness were independent risk factors for using higher-nicotine cigarettes, and use of higher-nicotine cigarettes increased risk for nicotine dependence. | Cigarettes | Addiction, Behavior |
| Parker et al. (2018) | U.S. National Sample | 2006–2014 | 58,971 (43.4%) | Nine years of cross-sectional NSDUH survey data were pooled to examine nicotine dependence severity as a function of OD8 status. Smokers with OD had greater severity of nicotine dependence and were more likely to be nicotine dependent than those without OD. The relationship between OD and nicotine dependence was attenuated but remained significant after adjusting for variables that differed between groups, such as depression, anxiety, alcohol, and other substance use. | Cigarettes | Addiction, Behavior |
| Gaalema et al. (2018a) | U.S. National Sample | 2013–2015 | 23,262 (47%) | Data from Waves 1 and 2 of the PATH study were used to compare tobacco use and attitudes as a function of level of cardiac risk. Use of combusted tobacco was higher among those with lifetime myocardial infarction (MI). Having a recent MI was associated with increased perception of tobacco harms and with increased quit or reduction attempts, but not with successful quitting or reduction. | Cigarettes, ENDS, Cigars, SLT, Snus, Pipe, Dissolvables, Hookah | Behavior |
| Stokes et al. (2018) | U.S. National Sample | 2014 | 4933 (54.2%) | Cross-sectional NHIS9 data were used to examine prevalence and patterns of ENDS use among adults with a history of cardiovascular disease (CVD). ENDS use was associated with past-year quitting and past-year quit attempts. | Cigarettes, ENDS | Behavior |
| Tidey et al. (2013) | Smokers with schizo-phrenia and controls in Rhode Island | NR | 56 (41%) | Double-blind, mixed-factors laboratory assessment of responses to VLNC10 cigarettes with placebo or 42?mg nicotine replacement (NRT). VLNC cigarettes combined with either placebo or NRT reduced craving, withdrawal symptoms, and usual brand smoking in both populations; VLNC cigarettes were less satisfying and rewarding than usual brand. | Research cigarettes | Addiction, Behavior |
| Tidey et al. (2016) | Smokers with schizo-phrenia and controls in Rhode Island | NR | 50 (46.5%) | Double-blind, mixed-factors laboratory assessment of responses to VLNC cigarettes with placebo or 42?mg nicotine replacement (NRT). Use of VLNC cigarettes increased puff duration and reduced time between puffs, but participants smoked fewer puffs, resulting in net decreases in volume of total smoke intake. | Research cigarettes | Addiction, Behavior, Toxicity |
| AhnAllen et al. (2015) | Smokers with schizo-phrenia and controls in Rhode Island | NR | 57 (40%) | Double-blind, mixed-factors laboratory assessment of responses to VLNC cigarettes with placebo or 42?mg nicotine replacement (NRT). Compared to a usual brand smoking condition, use of VLNC? +?placebo patches impaired cognitive performance in several domains; these impairments were reversed in the VLNC? +?NRT condition. | Research cigarettes | Behavior |
| Higgins et al. (2017a) | Smokers with affective disorders, opioid dependence, and low SES women in Vermont, Rhode Island, and Maryland | 2015–2016 | 169 (71%) | Multi-site, double-blind, within-participant laboratory assessment of subjective and behavioral responses to cigarettes varying in nicotine content. Reducing the nicotine content of cigarettes reduced subjective and behavioral indicators of cigarette addiction liability across populations. | Research cigarettes | Addiction, Behavior, Impact Analysis, Toxicity |
| Arger et al. (2017) | Smokers with affective disorders, opioid dependence, and low SES women in Vermont, Rhode Island, and Maryland | 2015–2016 | 169 (71%) | Secondary analysis of a multi-site, double-blind, within-participant laboratory assessment of responses to cigarettes varying in nicotine content. Across populations, Satisfaction and Aversion subscale scores on the Modified Cigarette Evaluation Questionnaire predicted cigarette choices as measured using a concurrent-choice behavioral task. | Research cigarettes | Addiction, Behavior, Impact Analysis |
| Higgins et al. (2017a) | Smokers with affective disorders, opioid dependence, and low SES women in Vermont, Rhode Island, and Maryland | 2014–2015 | 26 (77%) | Multi-site, double-blind, within-participant laboratory assessment of subjective and behavioral responses to cigarettes varying in nicotine content. Across populations, participants rated the VLNC cigarettes lower in satisfaction and made fewer choices for these puffs relative to NNC cigarette puffs in concurrent choice testing. All cigarettes reduced withdrawal symptoms and none increased puff intensity. | Research cigarettes | Addiction, Behavior, Impact Analysis |
| Higgins et al. (2018) | Smokers with affective disorders, opioid dependence, and low SES women in Vermont, Rhode Island, and Maryland | 2015–2016 | 169 (71%) | Secondary analysis of a multi-site, double-blind, within-participant laboratory assessment of responses to cigarettes varying in nicotine content, in which dependence severity was examined as a moderator of responses. Across populations, dependence severity did not moderate effects of nicotine content on measures of addiction liability or withdrawal, and had minimal effects on craving and topography. | Research cigarettes | Addiction, Behavior, Impact Analysis, Toxicity |
| Tidey et al. (2017) | Daily smokers from 10 sites | 2013–2014 | 717 (42.3%) | Secondary analysis of a multi-site, double-blind, randomized trial, in which depressive symptom severity was examined as a moderator of responses to normal-nicotine content (NNC) vs. VLNC cigarettes over a 6-week period. Effects of VLNC cigarettes on smoking were not moderated by depressive symptom severity. Among smokers with higher depression at baseline, those assigned to VLNC cigarettes had lower depression at week 6 than those assigned to NNC cigarettes. | Research cigarettes | Addiction, Behavior, Impact Analysis, Toxicity |
| Valentine et al. (2018) | Veteran smokers with psych-iatric or substance use disorders | NR | 43 (7%) | Open label study of ENDS provision (tank style; 12 or 24?mg/ml nicotine) on cigarette use over a 4-week period. Mean frequency of ENDS use was 5.7?days/week; significant reductions in cigarette use, dependence, and carbon monoxide levels, and increases in motivation to quit, were observed over time. | ENDS | Addiction, Behavior, Impact Analysis, Toxicity |
| Jamal et al. (2014) | Brazilians undergoing mandatory occupational health evaluation | NR | 5503 (21.2%) | Cross-sectional study examining relationships between smoking and metabolic syndrome (MetS) on risk factors for cardiovascular disease (CVD). The prevalence of MetS was higher among smokers than non-smokers, and smoking increased the risk of systemic inflammation among those with MetS. | Cigarettes | Health Effects |
| Veal et al. (2017) | Women with ductal carcinoma in situ (DCIS) in Wisconsin | 1997–2006 | 1925 (100%) | Longitudinal cohort study examining associations between body mass index, physical activity, alcohol consumption and smoking with mortality. All-cause and cancer-specific mortality were elevated among women who smoked pre-and post-diagnosis; all-cause mortality was reduced among women with greater levels of physical activity. | Cigarettes | Health Effects |
| Legro et al. (2014) | Women with polycystic ovary syndrome (PCOS) seeking fertility treatment | NR | 626 (100%) | Secondary analysis of a large randomized controlled study of infertility treatments in women with PCOS that examined whether smoking status was related to risk of infertility and response to infertility treatment. A sub sample was used to validate self-reported smoking status with cotinine level. Current smoking was associated with a more severe phenotype at baseline and a lower treatment response in terms of metabolic and reproductive risk factors. | Cigarettes | Behavior, Health Effects |
| Cooper et al. (2018) | Pregnant women in Vermont | NR | 93 (100%) | Analyzed effects of a randomized controlled trial of effects of abstinence-contingent vouchers on relationships between smoking, uterine blood flow and birth outcomes. No direct relationship between smoking and uterine artery hemodynamics was demonstrated. Volumetric flow was an independent contributor to birth weight and associated with fetal fat deposition; smoking was not independently associated with either outcome. | Cigarettes | Health Effects |
| White et al. (2018) | African Americans in Mississippi | 2000–2013 | 2991 (56.1%) | Longitudinal analysis of Jackson Heart Study examining associations between smoking and developing diabetes mellitus among those without diabetes mellitus at baseline. Baseline heavy smoking (20 or more cigarettes per day) and smoking pack-years were associated with increased risk of developing diabetes. Adjusting for waist circumference and hs-CRP minimally attenuated the incidence rate. | Cigarettes | Health Effects |
| Tidey et al. (2014) | Smokers with schizo-phrenia and controls in Rhode Island | NR | 55 (40%) | Double-blind, mixed-factors laboratory comparison of effects of 3-day smoking abstinence and reinstatement in smokers with and without schizophrenia. Smokers with schizophrenia had higher craving and withdrawal symptoms during abstinence, greater nicotine preference after abstinence, and relapsed sooner than controls. | Cigarettes | Behavior |
| Streck et al. (2018) | Smokers with opioid dependence and controls in Vermont | NR | 72 (42%) | Comparison of tobacco withdrawal symptoms among smokers with OD and those without substance use disorders who had received monetary incentives to experimentally induce smoking abstinence. Smokers with OD reported higher craving and withdrawal than controls prior to abstinence but both groups had similar reductions in withdrawal symptoms over time. Female controls had the greatest increase in craving after abstinence. | Cigarettes | Behavior |
1
Shared superscripts indicate shared samples across studies.
2
All of the studies described the gender/sex breakdown of their participants as male and/or female or as men and/or women. The studies did not address whether participants self-reported their assigned sex at birth and/or their gender identity at the time of the survey.
3
National Survey on Drug Use and Health.
4
Smokeless tobacco.
5
Electronic Nicotine Delivery System.
6
Population Assessment of Tobacco and Health.
7
Data not reported or could not be determined.
8
Opioid dependence.
9
National Health Interview Survey.
10
Very low nicotine content.