Associations between smoking and psychiatric comorbidity in U.S. Iraq- and Afghanistan-era veterans.

The risk of smoking increases with specific psychiatric diagnoses (e.g., posttraumatic stress disorder); but the risk has also been shown to increase as a function of the number of psychiatric illnesses with which a person is diagnosed. The current study examined this association and other correlates of smoking-psychiatric comorbidity in a sample of U.S. Iraq- and Afghanistan-era veterans who have served since September 11, 2001. The sample consisted of 1,691 veterans (Mage = 37.5 years, 20.2% women, 53.2% minority). Veterans completed measures of smoking history, nicotine dependence, and smoking expectancies; they also underwent a structured diagnostic interview to establish any current and/or lifetime psychiatric diagnoses. Consistent with previous studies, the number of comorbid diagnoses was significantly associated with both heavy (>20 cigarettes/day) and light-to-moderate (≤20 cigarette/day) smoking. Moreover, among current smokers, significant correlations between self-reported dependence and number of diagnoses were observed. Examination of self-reported smoking expectancies revealed that a greater number of diagnoses were associated with greater expectancies of negative affect reduction, stimulation and state enhancement, taste and sensorimotor manipulation, social facilitation, craving and addiction, and boredom reduction. The present findings confirm the association between the number of comorbid diagnoses reported in previous studies, and extends those findings by identifying smoking expectancies differences among smokers with comorbid diagnoses.