A PROSPECTIVE, HIGH-RISK STUDY OF THE RELATIONSHIP BETWEEN TOBACCO DEPENDENCE AND ALCOHOL-USE DISORDERS

This study examined the extent to which tobacco dependence (TD) and al cohol use disorders (AUDs) reciprocally influenced each other in a mix ed-gender sample of 452 individuals (n = 232 biological family history of paternal alcoholism, n = 220 no first- or second-degree family his tory of alcoholism) who were assessed once early in their freshman yea r of college, similar to 3 years later when many were college seniors, and similar to 3 years later when many had entered or were entering t he work force. AUDs were more prevalent in men than women, in individu als with a family history of alcoholism, and decreased overall with ti me. TD was more prevalent in those with a family history of alcoholism , showed increasing rates of use over time, and was less prevalent but more stable than AUDs. Transitional probabilities indicated that alth ough a previous AUD or TD diagnosis increased the likelihood of being diagnosed with the other disorder at a later time, comorbid AUDs and T D did not significantly affect the likelihood of recovery from either disorder. Finally, path analysis revealed significant reciprocal relat ionships between AUDs and TD diagnoses (each predicting the other over time), and significant prediction of AUDs and TD by family history of alcoholism at the first and third times of assessment. Findings suppo rted two general models of AUD/TD comorbidity: a shared vulnerability model and a reciprocal influence model.