Personality disorders and cigarette smoking among adults in the United States

Introduction: There is a paucity of empirical information pertaining to the association between personality disorders and cigarette smoking. The present study examined whether, and to what degree, personality disorders are associated with cigarette smoking; investigated the specificity of any observed smoking-personality disorder association; and the role of mood/anxiety disorders, substance use, and nicotine dependence in those relations. Methods: Data were drawn from the National Epidemiologic Survey of Alcohol and Related Conditions (NESARC), a nationally representative sample of 43,083 adults in the United States. Results: Results indicated a substantial percentage of those with personality disorders are nicotine dependent. Interestingly, the association between dependent, avoidant, histrionic, schizoid and paranoid personality disorders as well as former dependent smoking was partially explained by co-occurring mood/anxiety disorders, and adjusting for such clinical conditions appeared to generally attenuate the strength of many other associations. Finally, the association between personality disorders and smoking appears to differ by specific personality disorder, with some of the strongest relations being evident for antisocial personality disorder. Discussion: These novel empirical findings are discussed in relation to the relevance of cigarette smoking among those with personality disorders. (C) 2010 Elsevier Ltd. All rights reserved.