Introduction

Concurrent tobacco/alcohol use is common in adults, and associated with the severity of symptoms experienced by those with mental health disorders. However, few studies have explored this relationship across different combinations of tobacco products [i.e., conventional cigarette (CC) and electronic cigarette (EC)] and alcohol.

Methods

Data from the Wave 1 (2013-2014) Population Assessment of Tobacco and Health study were used. A total of 15,947 adults aged 18 years or older with complete study information were included. Multinomial logistic regression analyses were performed to determine the relationship between lifetime internalizing/externalizing severity and past 30-day use of tobacco and alcohol, adjusting for nicotine dependence (ND), sex, age, race, education, and income.

Results

Internalizing severity was more strongly associated with CC and alcohol use (moderate AOR= 1.47, 95% CI= 1.22-1.77; high AOR= 1.29, 95% CI= 1.03-1.61) as well as alcohol-exclusive use (moderate AOR= 1.58, 95% CI= 1.27-1.96; high AOR= 1.31, 95% CI= 1.05-1.64) while externalizing severity was more strongly associated with EC and alcohol use (high AOR= 2.97, 95% CI= 1.84-4.81, moderate AOR= 2.29, 95% CI= 1.53-3.43) when accounting for ND compared to none. The relationship between externalizing severity with EC use was dependent on alcohol being used with EC.

Conclusions

The associations between psychopathology (internalizing vs. externalizing severity) varies by different combinations of alcohol, CC, and EC. Further, these relationships may be mediated through ND. 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.

中文翻译：

---

内化和外化严重程度与成人目前使用香烟、电子烟和酒精之间的关联：烟草与健康人口评估 (PATH) 研究的第一波

 介绍

同时吸烟/饮酒在成年人中很常见，并且与精神健康障碍患者所经历的症状的严重程度相关。然而，很少有研究探讨烟草产品[即传统卷烟（CC）和电子烟（EC）]和酒精的不同组合之间的这种关系。

 方法

使用了第一波（2013-2014）烟草与健康人口评估研究的数据。共有 15,947 名年龄在 18 岁或以上、拥有完整研究信息的成年人参与其中。进行多项 Logistic 回归分析，以确定终生内化/外化严重程度与过去 30 天吸烟和饮酒之间的关系，并调整尼古丁依赖 (ND)、性别、年龄、种族、教育和收入。

 结果

内化严重程度与 CC 和饮酒（中度 AOR= 1.47，95% CI= 1.22-1.77；高 AOR= 1.29，95% CI= 1.03-1.61）以及仅饮酒（中度 AOR= 1.58）密切相关，95% CI= 1.27-1.96；高 AOR= 1.31，95% CI= 1.05-1.64），而外化严重程度与 EC 和饮酒密切相关（高 AOR= 2.97，95% CI= 1.84-4.81，中等 AOR） = 2.29，95% CI= 1.53-3.43）当考虑 ND 时与不考虑相比。外化严重程度与 EC 使用之间的关系取决于与 EC 一起使用的酒精。

 结论

精神病理学（内在严重性与外在严重性）之间的关联因酒精、CC 和 EC 的不同组合而异。此外，这些关系可以通过ND来调节。未来对精神障碍症状与吸烟和饮酒之间的共病的调查应考虑使用特定物质及其组合。