{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,16]],"date-time":"2026-02-16T19:03:12Z","timestamp":1771268592607,"version":"3.50.1"},"reference-count":16,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2023,7,6]],"date-time":"2023-07-06T00:00:00Z","timestamp":1688601600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100005188","name":"Tobacco-Related Disease Research Program","doi-asserted-by":"publisher","award":["T32KT4896"],"award-info":[{"award-number":["T32KT4896"]}],"id":[{"id":"10.13039\/100005188","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Psycho-Oncology"],"published-print":{"date-parts":[[2023,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Cancer patients often face multiple comorbidities and are at risk for various mental health conditions and substance use disorders. Tobacco\/nicotine dependence (TND) is a known risk factor for poor health outcomes and has been associated with psychiatric disorders including substance use disorder. However, the specific relationship between TND and the risk of substance use disorder and mental health conditions among cancer patients remains underexplored. This study aimed to assess the association between TND and the risk of comorbid conditions among cancer patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Data were obtained from a database of electronic health records for patients from the University of California health system. The odds for every condition among cancer patients with TND were calculated and compared with those for cancer patients without TND. ORs were adjusted for gender, ethnicity, and race.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Three thousand seven hundred and ninety\u2010one cancer patients with TND had 252,619 total conditions, and 51,711 cancer patients without TND had 2,310,880 conditions. After adjusting for confounders, the condition for which TND most exacerbated risk was psychoactive substance\u2010induced organic anxiety disorder (OR\u00a0=\u00a016.3, <jats:italic>p<\/jats:italic>\u00a0&lt;\u00a00.001). This appeared consistent with the second, third, and fifth most\u2010exacerbated conditions: stimulant use disorder (OR\u00a0=\u00a012.8, <jats:italic>p<\/jats:italic>\u00a0&lt;\u00a00.001), cocaine induced mental disorder (OR\u00a0=\u00a011.0, <jats:italic>p<\/jats:italic>\u00a0&lt;\u00a00.001), and cocaine use disorder (OR\u00a0=\u00a011.0, <jats:italic>p<\/jats:italic>\u00a0&lt;\u00a00.001). Different conditions exacerbated by TND include acute alcoholic intoxication (OR\u00a0=\u00a011.4, <jats:italic>p<\/jats:italic>\u00a0&lt;\u00a00.001), opioid use disorder (OR\u00a0=\u00a07.6, <jats:italic>p<\/jats:italic>\u00a0&lt;\u00a00.001), schizoaffective disorder (OR\u00a0=\u00a07.4, <jats:italic>p<\/jats:italic>\u00a0&lt;\u00a00.001), and cannabis use disorder (OR\u00a0=\u00a06.3, <jats:italic>p<\/jats:italic>\u00a0&lt;\u00a00.001).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Our findings reveal a strong association between TND and an increased risk of substance use disorder and mental health conditions among cancer patients. Specifically, cancer patients with TND were at an elevated risk for psychoactive substance\u2010induced organic anxiety disorder, stimulant use disorder, and cocaine\u2010related disorders. Additionally, TND was associated with an increased risk of acute alcoholic intoxication, opioid use disorder, schizoaffective disorder, and cannabis use disorder. These findings underscore the need for comprehensive screening and interventions to address TND and comorbid conditions among cancer patients.<\/jats:p><\/jats:sec>","DOI":"10.1002\/pon.6190","type":"journal-article","created":{"date-parts":[[2023,7,6]],"date-time":"2023-07-06T14:33:10Z","timestamp":1688653990000},"page":"1395-1400","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Tobacco\/nicotine dependence as a risk factor for substance use disorders and related mental health conditions among cancer patients"],"prefix":"10.1002","volume":"32","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8179-0619","authenticated-orcid":false,"given":"Raphael E.","family":"Cuomo","sequence":"first","affiliation":[{"name":"University of California, San Diego, School of Medicine  San Diego California USA"},{"name":"Global Health Policy and Data Institute  San Diego California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tim K.","family":"Mackey","sequence":"additional","affiliation":[{"name":"Global Health Policy and Data Institute  San Diego California USA"},{"name":"San Diego Supercomputer Center  San Diego California USA"},{"name":"Department of Anthropology University of California, San Diego  San Diego California USA"},{"name":"S\u20103 Research  San Diego California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vidya","family":"Purushothaman","sequence":"additional","affiliation":[{"name":"Global Health Policy and Data Institute  San Diego California USA"},{"name":"San Diego Supercomputer Center  San Diego California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2023,7,6]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.3322\/caac.21660"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/1099\u20101611(200101\/02)10:1<19::aid\u2010pon501>3.0.co;2\u20106"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1093\/ntr\/ntu115"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.28695"},{"key":"e_1_2_11_6_1","first-page":"3","article-title":"Tobacco and lung cancer: risks, trends, and outcomes in patients with cancer","volume":"38","author":"Warren GW","year":"2018","journal-title":"Am Soc Clin Oncol Educ Book"},{"issue":"10","key":"e_1_2_11_7_1","first-page":"1927","article-title":"The relationship of major depressive disorder and gender to changes in smoking for current and former smokers: longitudinal\u00a0evaluation in the US population","volume":"108","author":"Weinberger AH","year":"2013","journal-title":"Addiction"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1037\/bul0000003"},{"issue":"3","key":"e_1_2_11_9_1","first-page":"162","article-title":"An epidemiologic analysis of co\u2010occurring alcohol and tobacco use and disorders: findings from the National Epidemiologic Survey on Alcohol and Related Conditions","volume":"29","author":"Falk DE","year":"2006","journal-title":"Alcohol Res Health"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1080\/14622200802443569"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph19084555"},{"key":"e_1_2_11_12_1","unstructured":"COVID\u201019 clinical data sets for research. University of California. Accessed May 25 2022.https:\/\/www.ucbraid.org\/cords"},{"key":"e_1_2_11_13_1","unstructured":"National Cancer Institute.NCI dictionary of cancer terms. Accessed October 10 2023.https:\/\/www.cancer.gov\/publications\/dictionaries\/cancer\u2010terms\/"},{"key":"e_1_2_11_14_1","unstructured":"Ambry Genetics.Oncology ICD\u201010 code reference sheet. Accessed October 10 2023.https:\/\/www.ambrygen.com\/material\/oncology\/icd\u201010\u2010code\u2010reference\u2010sheets\/icd\u201010\u2010codes\u2010non\u2010breast\/631"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12885\u2010019\u20106472\u20109"},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.167.7.716"},{"key":"e_1_2_11_17_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamapsychiatry.2013.3726"}],"container-title":["Psycho-Oncology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/pon.6190","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,7]],"date-time":"2023-09-07T12:46:39Z","timestamp":1694090799000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/pon.6190"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,7,6]]},"references-count":16,"journal-issue":{"issue":"9","published-print":{"date-parts":[[2023,9]]}},"alternative-id":["10.1002\/pon.6190"],"URL":"https:\/\/doi.org\/10.1002\/pon.6190","archive":["Portico"],"relation":{},"ISSN":["1057-9249","1099-1611"],"issn-type":[{"value":"1057-9249","type":"print"},{"value":"1099-1611","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,7,6]]},"assertion":[{"value":"2023-04-04","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-06-27","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-07-06","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}