The association between internalizing and externalizing severity with current use of cigarettes, e-cigarettes, and alcohol in adults: Wave 1 of the Population Assessment of Tobacco and Health (PATH) study.

Introduction:
This text discusses a study on the association between internalizing and externalizing severity with current use of cigarettes, e-cigarettes, and alcohol in adults. The study uses data from the Wave 1 Population Assessment of Tobacco and Health (PATH) study and employs multinomial logistic regression analyses to determine the relationship between lifetime internalizing/externalizing severity and past 30-day use of tobacco and alcohol, adjusting for nicotine dependence, sex, age, race, education, and income.

Key Points:

* The study found that internalizing severity was more strongly associated with cigarette and alcohol use, as well as alcohol-exclusive use, while externalizing severity was more strongly associated with e-cigarette and alcohol use.
* The relationship between externalizing severity with e-cigarette use was dependent on alcohol being used with e-cigarettes.
* The associations between psychopathology (internalizing vs. externalizing severity) varied by different combinations of alcohol, cigarettes, and e-cigarettes.
* The relationships may be mediated through nicotine dependence.
* Future investigations into the comorbidity between mental disorder symptoms with tobacco and alcohol use should consider use of specific substances as well as their combination.
* The study used data from the Wave 1 Population Assessment of Tobacco and Health (PATH) study, which is a nationally representative longitudinal cohort study of the civilian, noninstitutionalized adult household population of the US.
* The study adjusted for nicotine dependence, sex, age, race, education, and income.

Main Message:
The study highlights the importance of considering specific combinations of tobacco products and alcohol when examining the relationship between mental health symptoms and substance use. The findings suggest that internalizing and externalizing symptoms are differentially associated with various combinations of cigarettes, e-cigarettes, and alcohol, and that nicotine dependence may play a mediating role. The results indicate the need for further research into the comorbidity between mental disorder symptoms and tobacco and alcohol use, taking into account the specific substances and their combinations.

Blondino CT, Clifford JS, Lu J, Prom-Wormley EC. The association between internalizing and externalizing severity with current use of cigarettes, e-cigarettes, and alcohol in adults: Wave 1 of the Population Assessment of Tobacco and Health (PATH) study. Addictive behaviors. 2021;119:106890. doi:10.1016/j.addbeh.2021.106890