The Association Between DSM-IV Nicotine Dependence and Stressful Life Events in the National Epidemiologic Survey on Alcohol and Related Conditions

Background and Objectives: Nicotine dependence (ND) is a pervasive public health concern and a leading cause of preventable mortality. Stressful life events (SLEs), which severely disrupt the lives of individuals experiencing such events, have been posited as correlates of persisting ND. While both ND and SLEs have been studied extensively in relation to other variables, there are few instances in which they have been investigated in concert. Methods: In this study, we use data on 18,013 smokers from the 2001-2002 data set of the National Epidemiological Survey on Alcohol and Related Conditions (NESARC, N = 43,093) to examine whether experiencing a SLE in the past 12 months was associated with meeting criteria for ND in the same past 12 months. Logistic regression analyses were conducted while accounting for a variety of covariates. Results: A majority of the SLEs were associated with past 12 month ND, even after controlling for poverty, psychiatric and substance use disorders, and a prior history of ND (odds-ratios 1.35-2.20). The rates of past 12 month ND were considerably greater in those experiencing more than one SLE. Conclusions: While these data do not allow us to make causal interpretations, our results suggest an association between SLE and ND. Potentially, individuals experiencing SLEs may find it difficult to quit smoking; alternatively, directly or via correlated risks (e.g., living in a high risk neighborhood), smoking may increase the likelihood of exposure to SLEs.