Skip to main content

Advertisement

Log in

Marijuana Use Among Daily Tobacco Smokers: Relationship to Anxiety-Related Factors

  • Published:
Journal of Psychopathology and Behavioral Assessment Aims and scope Submit manuscript

Abstract

The present investigation evaluated the incremental validity of regular marijuana use and frequency of such use in relation to anxiety and depressive symptoms and perceived health among young adult tobacco smokers (n = 202). Approximately 72% of the sample were current marijuana smokers, using this drug on an average of 7.6 (SD = 9.2) times per week. As expected, after controlling for theoretically-relevant smoking (cigarettes per day), alcohol use, and affect factors (i.e., negative affectivity and anxiety sensitivity), marijuana use predicted anxiety symptoms and perceived general health, whereas frequency of marijuana use predicted only anxiety symptoms. These results are discussed in relation to better understanding the role of regular marijuana use in terms of anxiety-relevant emotional vulnerability and beliefs about physical health among regular smokers.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  • Abelson, R. P. (1985). A variance explanation paradox: When a little is a lot. Psychological Bulletin, 97, 129–133.

    Google Scholar 

  • Adams, I. B., & Martin, B. R. (1996) Cannabis: Pharmacology and toxicology in animals and humans. Addiction, 91, 1585–1614.

    CAS  PubMed  Google Scholar 

  • Amos, A., Wiltshire, S., Bostock, Y., Haw, S., & McNeill, A. (2004). You can’t go without a fag ... you need it for your hash—A qualitative exploration of smoking, cannabis, and young people. Addiction, 99, 77–81.

    PubMed  Google Scholar 

  • Block, R., & Ghoneim, M. M. (1993). Effects of chronic marijuana use on human cognition. Psychopharmacology, 110, 219–228.

    CAS  PubMed  Google Scholar 

  • Block, J. H., Gjerde, P. F., & Block, J. H. (1991). Personality antecedents of depressive tendencies in 18-year-olds: A prospective study. Journal of Personality and Social Psychology, 60, 726–738.

    CAS  PubMed  Google Scholar 

  • Boyd, J. H. (1986). Use of mental health services for the treatment of panic disorder. American Journal of Psychiatry, 143, 1569–1574.

    CAS  PubMed  Google Scholar 

  • Brook, J. S., Rosen, Z., & Brook, D. W. (2001). The effect of early marijuana use on later anxiety and depressive symptoms. NYS Psychologist, 13, 35–40.

    Google Scholar 

  • Brown, R. A., Lejuez, C. W., Kahler, C. W., & Strong, D. R. (2002). Distress tolerance and duration of past smoking cessation attempts. Journal of Abnormal Psychology, 111, 180–185.

    PubMed  Google Scholar 

  • Chen, C., Wagner, F. A., & Anthony, J. C. (2002). Marijuana use and the risk of major depressive episode: Epidemiologic evidence from the United States National Comorbidity Survey. Social Psychiatry & Psychiatric Epidemiology, 37, 199–206.

    Google Scholar 

  • Cohen, J. & Cohen, P. (1983). Applied multiple regression/correlation analysis for the behavioral sciences. Hillsdale, NJ: Erlbaum.

    Google Scholar 

  • Cohen, S. (1981). Adverse effects of marijuana: Selected issues. Annals of the New York Academy of Sciences, 362, 119–124.

    CAS  PubMed  Google Scholar 

  • Comeau, N., Stewart, S. H., & Loba, P. (2001). The relations of trait anxiety, anxiety sensitivity, and sensation seeking to adolescents’ motivations for alcohol, cigarette, and marijuana use. Addictive Behaviors, 26, 803–825.

    CAS  PubMed  Google Scholar 

  • Covey, L. S., Glassman, A. H., & Stetner, F. (1998). Cigarette smoking and major depression. Journal of Addictive Diseases, 17, 35–46.

    CAS  Google Scholar 

  • Degenhardt, L., Hall, W., & Lynskey, M. (2001). The relationship between cannabis use, depression and anxiety among Australian adults: Findings from the National Survey of Mental Health and Well-Being. Social Psychiatry & Psychiatric Epidemiology, 36, 219–227.

    Google Scholar 

  • DiNardo, P. A., Brown, T. A., & Barlow, D. H. (1994). The anxiety disorders interview schedule for DSM-IV. Albany, NY: Graywind Publications.

    Google Scholar 

  • Farrow, J. A., Rees, J. M., & Worthington-Roberts, B. S. (1987). Health, developmental, and nutritional status of adolescent alcohol and marijuana abusers. Pediatrics, 79, 218–223.

    CAS  PubMed  Google Scholar 

  • Feldner, M. T., Zvolensky, M. J., & Schmidt, N. B. (2004). Prevention of anxiety psychopathology: A critical review of the empirical literature. Clinical Psychology: Science and Practice, 11, 405–424.

    Google Scholar 

  • Fergusson, D. M., Goodwin, D. M., & Horwood, L. J. (2003). Major depression and cigarette smoking: Results of a 21-year longitudinal study. Psychological Medicine, 33, 1357–1367.

    CAS  PubMed  Google Scholar 

  • Graham, A. W., Schultz, T. K., & Wilford, B. B. (Eds.) (1998). Principles of addiction medicine (2nd ed.). Chevy Chase. MD: American Society of Addition Medicine Inc.

    Google Scholar 

  • Green, B. E., & Ritter, C. (2000). Marijuana use and depression. Journal of Health & Social Behavior, 41, 40–49.

    Google Scholar 

  • Hall, S. M., Muñoz, R. F., & Reus, V. I. (1994). Cognitive-behavioral intervention increases abstinence rates for depressive-history smokers. Journal of Consulting and Clinical Psychology, 62, 141–146.

    CAS  PubMed  Google Scholar 

  • Haynes, S. N., & Lench, H. C. (2003). Incremental validity of new clinical assessment measures. Psychological Assessment, 15, 456–466.

    PubMed  Google Scholar 

  • Herkenham, M., Lynn, A. B., Little, M. D., Johnson, M. R., Melvin, L. S., de Costa, B. R., & Rice, K. C. (1990). Cannabinoid receptor localization in brain. Proceedings of the National Academy of Sciences, 87, 1932–1936.

    CAS  Google Scholar 

  • Hornik, R., Maklan, D., Cadell, D., Prado, A., Barmada, C., Jacobsohn, L., Orwin, R., Sridharan, S., Zador, P., Southwell, B., Zanutto, E., Baskin, R., Chu, A., Morin, C., Taylor, K., and Steele, D. (2002). Evaluation of the National Youth Anti-Drug Media Campaign: Fourth semi-annual report of findings. Report prepared for the National Institute on Drug Abuse (Contract No. N01DA–8–5063), Washington DC: Westat.

  • Idler, E. L., & Angel, R. J. (1990). Self-rated health and mortality in NHANES-I epidemiologic follow-up study. American Journal of Public Health, 80, 446–452.

    CAS  PubMed  Google Scholar 

  • Idler, E. L., & Kasl, S. (1991). Health perceptions and survival: Do global evaluations of health status really predict mortality? Journals of Gerontology, 46, 55–65.

    Google Scholar 

  • Isensee, B., Wittchen, H., Stein, M. B., Hofler, M. & Lieb, R. (2003). Smoking increases the risk of panic: Findings from a prospective community study. Archives of General Psychiatry, 60, 692–700.

    PubMed  Google Scholar 

  • Johnson, J. G., Cohen, P., Pine, D. S., Klein, D. F., Kasen, S., & Brook, J. S. (2000). Association between cigarette smoking and anxiety disorders during adolescence and early adulthood. Journal of the American Medical Association, 284, 2348–2351.

    CAS  PubMed  Google Scholar 

  • Johnston, L. D., O’Malley, P. M., & Bachman, J. G. (2002). Monitoring the future national results on adolescent drug use: Overview of key findings, 2001 (NIH Publication No. 02-5105). Bethesda, MD: National Institute on Drug Abuse.

    Google Scholar 

  • Leventhal, H., Leventhal, E., & Cameron, L. D. (2001). Representations, procedures, and affect in illness self regulation: A perceptual-cognitive approach. In A. Baum, T. Revenson, & J. Singer (Eds.), Handbook of health psychology (pp. 19–48). New York: Erlbaum.

    Google Scholar 

  • Lewinsohn, P., Rohde, P., & Brown, R. A. (1999). Level of current and past adolescent cigarette smoking as predictors of future substance use disorders in young adulthood. Addiction, 94, 913–921.

    CAS  PubMed  Google Scholar 

  • McNally, R. J. (1996). Anxiety sensitivity is distinct from trait anxiety. In R. M. Rapee (Ed.), Current controversies in the anxiety disorders (pp. 214–227). New York: Guilford.

    Google Scholar 

  • Mossey, J. M., & Shapiro, E. (1982). Self-rated health: A predictor of mortality among the elderly. American Journal of Public Health, 72, 800–808.

    CAS  PubMed  Google Scholar 

  • Office of Applied Studies. (2001). Summary of findings from the 2000 National Household Survey on Drug Abuse (DHHS Publication No. SMA 01-3549, NHSDA Series H-13; available at /nhsda.htm). Rockville, MD: Substance Abuse and Mental Health Services Administration.

    Google Scholar 

  • Perloff, L. S. (1987). Social comparison and illusions of invulnerability to negative life events. In C. R. Snyder, & C. Ford (Eds.), Coping with negative life events: clinical and social psychological perspectives on negative life events (pp. 217–242). Plenum Press.

  • Peterson, R. A., & Reiss, S. (1992). Anxiety Sensitivity Index Manual (2nd ed.). Worthington, OH: International Diagnostic Systems.

    Google Scholar 

  • Piper, M. E., Piasecki, T. M., Federman, E. B., Bolt, D. M., Smith, S. S., Fiore, M. C., & Baker, T. B. (2004). A multiple motives approach to tobacco dependence: The Wisconsin Inventory of Smoking Dependence Motives (WISDM-68). Journal of Consulting and Clinical Psychology, 72, 139–154.

    PubMed  Google Scholar 

  • Polen, M. R., Sidney, S., Tekawa, I. S., Sadler, M., & Friedman, D. (1993). Health care use by frequent marijuana smokers who do not smoke tobacco. The Western Journal of Medicine, 158, 596–601.

    CAS  PubMed  Google Scholar 

  • Rapee, R., & Medoro, L. (1994). Fear of physical sensations and trait anxiety as mediators of the response to hyperventilation in nonclinical subjects. Journal of Abnormal Psychology, 4, 693–699.

    Google Scholar 

  • Reiss, S., & McNally, R. J. (1985). Expectancy model of fear. In S. Reiss & R. R. Bootzin (Eds.), Theoretical Issues in Behavior Therapy (pp. 107–121). San Diego: Academic Press.

    Google Scholar 

  • Reiss, S., Peterson, R. A., Gursky, M., & McNally, R. J. (1986). Anxiety, sensitivity, anxiety frequency, and the prediction of fearfulness. Behaviour Research and Therapy, 24, 1–8.

    CAS  PubMed  Google Scholar 

  • Sanderson, W. C., Rapee, R. M., & Barlow, D. H. (1989). The influence of illusion of control on panic attacks induced by 5.5% carbon dioxide enriched air. Archives of General Psychiatry, 46, 157–162.

    CAS  PubMed  Google Scholar 

  • Sechrest, L. (1963). Incremental validity: A recommendation. Educational and Psychological Measurement, 23, 153–158.

    Google Scholar 

  • Schmidt, N. B., Joiner, T. E., Staab, J. P., & Williams, F. M. (2003). Health perceptions and anxiety sensitivity in patients with panic disorder. Journal of Psychopathology & Behavioral Assessment, 25, 139–145.

    Google Scholar 

  • Schmidt, N. B., & Telch, M. J. (1997). Nonpsychiatric medical comorbidity, health perceptions, and treatment outcome in patients with panic disorder. Health Psychology, 16, 114–122.

    CAS  PubMed  Google Scholar 

  • State of Vermont Department of Health (2000). Retrieved September 3, 2002, from http://www.healthyvermonters.info/.

  • Stephens, R. S. (1999). Cannabis and hallucinogens. In B. S. McCrady & E. E. Epstein (Eds.), Addictions: A comprehensive Guidebook (pp. 121–140). London: Oxford University Press.

    Google Scholar 

  • Stewart, A. L., Hays, R. D., & Ware, J. E. (1988). The MOS short-form general health survey: Reliability and validity in a patient population. Medical Care, 26, 724–735.

    CAS  PubMed  Google Scholar 

  • Stewart, S. H., Peterson, J. B., & Pihl, R. O. (1995). Anxiety sensitivity and self-reported alcohol consumption rates in university women. Journal of Anxiety Disorders, 9, 283–292.

    Google Scholar 

  • The National Center on Addiction and Substance Abuse at Columbia University and The American Legacy Foundation (2003). Report on teen cigarette smoking and marijuana use. New York, NY: Author.

    Google Scholar 

  • Wang, M. Q., Fitzhugh, E. C., Turner, L., Fu, Q., & Westerfield, C. (1996). Association of depressive symptoms and school adolescents’ smoking: A cross-lagged analysis. Psychological Reports, 79, 127–130.

    CAS  PubMed  Google Scholar 

  • Watson, D. (2000). Mood and temperament. New York: Guilford Press.

    Google Scholar 

  • Watson, D., Clark, L. A., & Tellegen, A. (1988). Development and validation of brief measures of positive and negative affect: The PANAS scales. Journal of Personality and Social Psychology, 54, 1063–1070.

    CAS  PubMed  Google Scholar 

  • Watson, D., Weber, K., Assenheimer, J. S., Clark, L. A., Strauss, O., & McCormick, J. (1995). Testing a tripartite model: I. Evaluating the convergent and discriminant validity of anxiety and depression symptom scales. Journal of Abnormal Psychology, 104, 3–14.

    CAS  PubMed  Google Scholar 

  • Wechsler, H., Davenport, A., Dowdall, G., Moeykens, B., & Castillo, S. (1994). Health and behavioral consequences of binge drinking in college. Journal of the American Medical Association, 272, 1672–1677.

    CAS  PubMed  Google Scholar 

  • Windle, M., & Windle, R. C. (2001). Depressive symptoms and cigarette smoking among middle adolescents: Prospective associations, and intrapersonal and interpersonal influences. Journal of Consulting and Clinical Consulting Psychology, 69, 215–226.

    CAS  Google Scholar 

  • Zhang, Z., Morgenstern, H., Spitz, M. R., Tashkin, D. P., Yu, G., Marshall, J. R., Hsu, T. C., & Schantz, S. P. (1999). Marijuana use and increased risk of squamous cell carcinoma of the head and neck. Cancer Epidemiology, Biomarkers and Prevention, 8, 1071–1078.

    Google Scholar 

  • Zinbarg, R. E., Barlow, D. H., & Brown, T. A. (1997). Hierarchical structure and general factor structure saturation of the Anxiety Sensitivity Index: Evidence and implications. Psychological Assessment, 9, 277–284.

    Google Scholar 

  • Zvolensky, M. J., Baker, K. M., Leen-Feldner, E. W., Bonn-Miller, M. O., Feldner, M. T., & Brown, R. A. (2004). Anxiety sensitivity: Association with intensity of retrospectively-rated smoking-related withdrawal symptoms and motivation to quit. Cognitive Behaviour Therapy, 33, 114–125.

    PubMed  Google Scholar 

  • Zvolensky, M. J., Eifert, G. H., & Lejuez, C. W. (2001). Emotional control during recurrent 20% carbon dioxide-enriched air induction: Relation to individual difference variables. Emotion, 2, 148–165.

    Google Scholar 

  • Zvolensky, M. J., Feldner, M. T., Leen-Feldner, E. W., & McLeish, A. (in press). Smoking and panic attacks, panic disorder, and agoraphobia: A review of the empirical literature. Clinical Psychology Review.

  • Zvolensky, M. J., Kotov, R., Antipova, A. V., & Schmidt, N. B. (2003). Cross cultural evaluation of smokers risk for panic and anxiety pathology: A test in a Russian epidemiological Sample. Behaviour Research and Therapy, 41, 1199–1215.

    PubMed  Google Scholar 

  • Zvolensky, M. J., Leen-Feldner, E. W., Feldner, M. T., Bonn-Miller, W. O., Lejuez, C. W., Kahler, C., & Stuart, G. (2004). Emotional responding to biological challenge as a function of panic disorder and smoking. Journal of Anxiety Disorders, 18, 19–32.

    PubMed  Google Scholar 

  • Zvolensky, M. J., Lejuez, C. W., Kahler, C. W., & Brown, R. A. (2003). Integrating an interoceptive exposure-based smoking cessation program into the cognitive-behavioral treatment of panic disorder: Theoretical relevance and case demonstration. Cognitive & Behavioral Practice, 10, 347–357.

    Google Scholar 

  • Zvolensky, M. J., Lejuez, C. W., Kahler, C. W., & Brown, R. A. (2004). Nonclinical panic attack history and smoking cessation: An initial examination. Addictive Behaviors, 29, 825–830.

    PubMed  Google Scholar 

  • Zvolensky, M. J., Schmidt, N. B., Antony, M. M., McCabe, R. E., Forsyth, J. P., Feldner, M. T., Leen-Feldner, E. W., Karekla, M., & Kahler, C. W. (in press). Evaluating the role of panic disorder in emotional sensitivity processes involved with smoking. Journal of Anxiety Disorders.

  • Zvolensky, M. J., Schmidt, N. B., & Stewart, S. H. (2003). Panic disorder and smoking. Clinical Psychology: Science and Practice, 10, 29–51.

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Michael J. Zvolensky.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Bonn-Miller, M.O., Zvolensky, M.J., Leen-Feldner, E.W. et al. Marijuana Use Among Daily Tobacco Smokers: Relationship to Anxiety-Related Factors. J Psychopathol Behav Assess 27, 279–289 (2005). https://doi.org/10.1007/s10862-005-2408-6

Download citation

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10862-005-2408-6

Key Words

Navigation