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Cigarette smoking and its relationship to other substance use among eating disordered inpatients

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Eating and Weight Disorders - Studies on Anorexia, Bulimia and Obesity Aims and scope Submit manuscript

Abstract

Objective: The present study examines prevalence rates of tobacco, caffeine, alcohol and other substance use and abuse among eating disordered inpatients and compares smokers (regular vs occasional vs non-smokers) and eating disorder (ED) subtypes [anorexia nervosa (AN) vs bulimia nervosa (BN); restrictors vs purgers] on substance use behaviors, family history, depressive symptoms and impulsivity. Method: Participants were 100 ED inpatients who completed assessment upon treatment entry. Results: A high incidence of regular cigarette smoking (29%) and occasional smoking (13%) was detected and associations were found with caffeine abuse, alcohol and marijuana use, family history and depression. BNs were more likely to smoke occasionally and use alcohol than ANs, while Purgers demonstrated higher caffeine and alcohol use than Restrictors. Discussion: Comprehensive assessment and intervention for smoking, caffeine and other substance use among ED patients is clearly indicated.

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References

  1. Mitchell J.E., Hatsukami D., Pyle R., Eckert E.: Bulimia with and without a family history of drug abuse. Addict. Behav., 13, 245–251, 1988.

    Article  CAS  PubMed  Google Scholar 

  2. Holderness C.C., Brooks-Gunn J., Warren M.P.: Co-morbidity of eating disorders and substance abuse review of the literature. Int. J. Eat. Disord., 16, 1–34, 1994.

    Article  CAS  PubMed  Google Scholar 

  3. Deal C.L.: Osteoporosis: Prevention, diagnosis, and management. Am. J. Med., 102(Suppl. 1A), 35S–39S, 1997.

    Article  CAS  PubMed  Google Scholar 

  4. McCulloch R.C., Whiting S.J., Bailey D.A., Houston C.S.: The effect of cigarette smoking on trabecular bone density in pre-menopausal women aged 20–35 years. Can. J. Public Health, 82, 434–435, 1991.

    CAS  PubMed  Google Scholar 

  5. Breslau N.: Psychiatric comorbidity of smoking and nicotine dependence. Behav. Genet., 25, 95–101, 1995.

    Article  CAS  PubMed  Google Scholar 

  6. Breslau N., Kilbey M.M., Andreski P.: DSM-III-R nicotine dependence in young adults: prevalence, correlates, and associated psychiatric disorders. Addiction, 89, 743–754, 1994.

    Article  CAS  PubMed  Google Scholar 

  7. Bulik C.M., Sullivan P.F., Epstein L.H.: Drug use in women with anorexia and bulimia nervosa. Int. J. Eat. Disord., 11, 213–225, 1992.

    Article  Google Scholar 

  8. Welch S.L., Fairburn C.G.: Smoking and bulimia nervosa. Int. J. Eat. Disord., 23, 433–437, 1998.

    Article  CAS  PubMed  Google Scholar 

  9. Wiseman C.V., Turco R.M., Sunday S.R., Halmi K.A.: Smoking and body image concerns in adolescent girls. Int. J. Eat. Disorders, 24, 429–433, 1998.

    Article  CAS  Google Scholar 

  10. Toner B.B., Garfinkel P.E., Garner D.M.: Long-term follow-up of anorexia nervosa. Psychosom. Med., 48, 520–529, 1986.

    CAS  PubMed  Google Scholar 

  11. Griffiths R.R., Mumford G.K.: Caffeine — A drug of abuse? Psychopharmacology. In Bloom F.E., Kupfer D. (Eds.), The fourth generation of progress. New York, Raven Press, 1995.

    Google Scholar 

  12. Sours J.A.: Case reports of anorexia nervosa and caffeinism. Am. J. Psychiatry, 140, 235–236, 1983.

    CAS  PubMed  Google Scholar 

  13. Krahn D.D., Hasse S., Ray A., Gosnell B., Drewnowski A.: Caffeine consumption in patients with eating disorders. Hospital and Community Psychiatry, 42, 313–315, 1991.

    CAS  PubMed  Google Scholar 

  14. Shaul P.W., Farrell M.K., Maloney M.J.: Caffeine toxicity as a cause acute psychosis in anorexia nervosa. Pediatr., 105, 493–495, 1984.

    CAS  Google Scholar 

  15. Bulik C.M.: Drug and alcohol abuse by bulimic women and their families. Am. J. Psychiatry, 144, 1604–1606, 1987.

    CAS  PubMed  Google Scholar 

  16. Reiger D.A., Farmer M.E., Rae D.S., Locke B.Z., Keith S.J., Judd L.L., Goodwin F.K.: Comorbidity of mental disorders with alcohol and other drug abuse. J.A.M.A., 264, 2511–2518, 1990.

    Article  Google Scholar 

  17. Kennedy S.H., Kaplan A.S., Garfinkel P.E., Rockert W., Toner B., Abbey S.E.: Depression in anorexia and bulimia nervosa: Discriminating depressive symptoms and episodes. J. Psychosom. Res., 38, 773–782, 1994.

    Article  CAS  PubMed  Google Scholar 

  18. Garfinkel P.E., Moldofsky H., Garner D.: The heterogeneity of anorexia nervosa. Arch. Gent. Psychiatry, 37, 1036–1040, 1980.

    Article  CAS  Google Scholar 

  19. Shiffman S., Kassel J.D., Paty J.A., Gyns M., Zettler-Segal M.: Smoking typology profiles of chippers and regular smokers. J. Subst. Abuse, 6, 21–35, 1994.

    Article  CAS  PubMed  Google Scholar 

  20. Beck A.T., Steer R.A.: Beck Depression Inventory. San Antonio, The Psychological Corporation, 1987.

    Google Scholar 

  21. Piotrowski C., Sherry D., Keller J.W.: Psycodiagnostic test usage: A survey of the Society for Personality Assessment. Journal of Personality Assessment, 49, 115–119, 1985.

    Article  CAS  PubMed  Google Scholar 

  22. Garner D.M.: Eating Disorder Inventory-2. Odessa, Psychological Assessment Resources. Inc. Florida, 1991.

    Google Scholar 

  23. Pomerleau C.S.: Co-factors for smoking and evolutionary psychobiology. Addiction, 92, 387–408, 1997.

    Article  Google Scholar 

  24. Dansky B.S., Brewerton T.D., Kilpatrick D.G.: Comorbidity of bulimia nervosa and alcohol use disorders: Results from the National Women’s Study. Int. J. Eat. Disord., 27, 180–190, 2000.

    Article  CAS  PubMed  Google Scholar 

  25. Kendler K.S., Neale M.C., MacLean C.J., Heath A.C., Eaves I.J., Kessler R.C.: Smoking and major depression: A causal analysis. Arch. Gent. Psychiatry, 50, 36–43, 1993.

    Article  CAS  Google Scholar 

  26. Vitousek K., Manke F.: Personality variables and disorders in anorexia nervosa and bulimia nervosa. J. Abnorm. Psychol., 103, 137–147, 1994.

    Article  CAS  PubMed  Google Scholar 

  27. Costa P.T., McCrae R.R.: NEO Personality Inventory-Revised. Odessa, Psychological Assessment Resources. Inc. Florida, 1992.

    Google Scholar 

  28. McLellan A.T., Luborsky L., Woody G.E., O’Brien C.P.: An improved diagnostic evaluation instrument for substance abuse patients, the Addiction Severity Index. J. N. Ment. Dis., 168, 26–33, 1980.

    Article  CAS  Google Scholar 

  29. Klesges R., Meyers M., Klesges L., Lavasque M.: Smoking, body weight, and their effects on smoking behavior: A comprehensive review of the literature. Psychol. Bull., 106, 204–230, 1998.

    Article  Google Scholar 

  30. Stitzer M.L., Walsh S.L.: Psychostimulant abuse: The case for combined behavioral and pharmacological treatments. Pharmacol. Biochem. Behav., 57, 457–470, 1997.

    Article  CAS  PubMed  Google Scholar 

  31. Jorenby D.E., Leischow S.J., Nides M.A., Rennard S.I., Johnston J.A., Hughes A.R., Smith S.S., Muramoto M.L., Daughton M.S., Doan K., Fiore M.C., Baker T.B.: Effect of sustained release bupropion, a nicotine patch, or their combination for smoking cessation. N. Engl. J. Med., 340, 685–691, 1999.

    Article  CAS  PubMed  Google Scholar 

  32. Hall S.M., Reus V.I., Sees K.L., Humfleet G., Hartz D.T., Triffleman E.: Nortriptyline and cognitive-behavioral therapy in the treatment of cigarette smoking. Arch. Gen. Psychiatry, 55, 683–690, 1998.

    Article  CAS  PubMed  Google Scholar 

  33. First M.B., Spitzer R.L., Gibbon M., Williams J.B.W.: Structured Clinical Interview for DSM-IV Axis I Disorders. New York, Biometrics Research, 1996.

    Google Scholar 

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Authors and Affiliations

  1. Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA

    Nancy A. Haug, L. J. Heinberg & A. S. Guarda

Authors
  1. Nancy A. Haug
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  2. L. J. Heinberg
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  3. A. S. Guarda
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Additional information

An earlier version of this paper was presented at the International Conference of Eating Disorders, New York, NY, May 4–7, 2000. This research was partially supported by NIDA individual fellowship F31 DA05980 awarded to the first author.

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Haug, N.A., Heinberg, L.J. & Guarda, A.S. Cigarette smoking and its relationship to other substance use among eating disordered inpatients. Eat Weight Disord 6, 130–139 (2001). https://doi.org/10.1007/BF03339762

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  • DOI: https://doi.org/10.1007/BF03339762

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