{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T15:23:55Z","timestamp":1791213835788,"version":"4.1.0"},"reference-count":35,"publisher":"Oxford University Press (OUP)","issue":"8","license":[{"start":{"date-parts":[[2023,4,12]],"date-time":"2023-04-12T00:00:00Z","timestamp":1681257600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"DOI":"10.13039\/100000054","name":"National Cancer Institute","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000054","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,7,14]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Introduction<\/jats:title>\n                  <jats:p>No studies have prospectively explored the association between the use of tobacco or cannabis use and the age of onset of depressive or anxiety symptoms, and no studies have identified the peak ages and ranges of onset of these symptoms among tobacco and\/or cannabis users.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Aims and Methods<\/jats:title>\n                  <jats:p>This is a secondary analysis of Texas Adolescent Tobacco and Marketing Surveillance System data, waves 9\u201314 (2019\u201320121). Participants were in 10th grade, 12th grade, and 2 years post-high school (HS) at baseline (wave 9). Interval-censoring multivariable Cox proportional hazards models were fit to assess differences in the estimated age of onset of depression and anxiety by tobacco and cannabis use while adjusting for covariates.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>We found that lifetime or ever cigarette, e-cigarette, and cannabis use had an increased risk of an earlier age of onset of depressive and anxiety symptoms across the three cohorts, and the youngest cohort was the most differentially impacted by substance use. Between ages 18 to 19 years in the 10th-grade cohort, between ages 20 to 21 years in the 12th-grade cohort, and between ages 22 to 23 years in the post-HS cohort, the estimated hazard function (or cumulative incidence) for reporting depressive and anxiety symptoms almost doubled among lifetime cigarette, e-cigarette, and cannabis users.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Tobacco and cannabis users should be screened for mental health problems at an earlier age, especially those aged 18 years and younger, and provided with age- and culturally appropriate resources to prevent or delay the onset of anxiety and\/or depression symptoms.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Implications<\/jats:title>\n                  <jats:p>The study\u2019s findings indicate that tobacco and cannabis use is directly linked to the early onset of depressive and anxiety symptoms among youth. This highlights the significance of early screening and substance use interventions, particularly for youth aged 18 years and younger, as they are disproportionately affected by both substance use and mental health problems. School-based interventions that are age- and culturally appropriate hold promise as they enable youth to seek professional help early, and in a supportive environment. Intervening early in substance shows promise in reducing the likelihood of developing mental health problems at a young age.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ntr\/ntad058","type":"journal-article","created":{"date-parts":[[2023,4,12]],"date-time":"2023-04-12T09:54:37Z","timestamp":1681293277000},"page":"1455-1464","source":"Crossref","is-referenced-by-count":33,"title":["The Association Between Tobacco and Cannabis Use and the Age of Onset of Depression and Anxiety Symptoms: Among Adolescents and Young Adults"],"prefix":"10.1093","volume":"25","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9505-3807","authenticated-orcid":false,"given":"Bara S","family":"Bataineh","sequence":"first","affiliation":[{"name":"School of Public Health, University of Texas Health Science Center at Houston , Dallas, TX , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna V","family":"Wilkinson","sequence":"additional","affiliation":[{"name":"School of Public Health, University of Texas Health Science Center at Houston (UTHealth) , Austin, TX , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6623-8543","authenticated-orcid":false,"given":"Aslesha","family":"Sumbe","sequence":"additional","affiliation":[{"name":"School of Public Health, University of Texas Health Science Center at Houston (UTHealth) , Austin, TX , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3890-9733","authenticated-orcid":false,"given":"Stephanie L","family":"Clendennen","sequence":"additional","affiliation":[{"name":"School of Public Health, University of Texas Health Science Center at Houston (UTHealth) , Austin, TX , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Baojiang","family":"Chen","sequence":"additional","affiliation":[{"name":"School of Public Health, University of Texas Health Science Center at Houston (UTHealth) , Austin, TX , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6685-2175","authenticated-orcid":false,"given":"Sarah E","family":"Messiah","sequence":"additional","affiliation":[{"name":"School of Public Health, University of Texas Health Science Center at Houston , Dallas, TX , USA"},{"name":"Center for Pediatric Population Health, UTHealth Houston School of Public Health , Dallas, TX , USA"},{"name":"Department of Pediatrics, McGovern Medical School , Houston, TX USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Melissa B","family":"Harrell","sequence":"additional","affiliation":[{"name":"School of Public Health, University of Texas Health Science Center at Houston (UTHealth) , Austin, TX , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2023,4,12]]},"reference":[{"key":"2023071411353519500_CIT0001","volume-title":"Key substance use and mental health indicators in the United States: Results from the 2020 National Survey on Drug Use and Health (HHS Publication No. PEP21-07-01-003, NSDUH Series H-56)","author":"Substance Abuse and Mental Health Services Administration.","year":"2021"},{"issue":"3","key":"2023071411353519500_CIT0002","doi-asserted-by":"crossref","first-page":"336","DOI":"10.1007\/s40429-018-0214-y","article-title":"Cannabis and mood disorders","volume":"5","author":"Lucatch","year":"2018","journal-title":"Curr Addict Rep"},{"issue":"16","key":"2023071411353519500_CIT0003","doi-asserted-by":"crossref","first-page":"3397","DOI":"10.1113\/JP270492","article-title":"Nicotine and the adolescent brain","volume":"593","author":"Yuan","year":"2015","journal-title":"J Physiol."},{"issue":"12","key":"2023071411353519500_CIT0004","doi-asserted-by":"crossref","first-page":"543","DOI":"10.3390\/jcm7120543","article-title":"Examining the association and directionality between mental health disorders and substance use among adolescents and young adults in the U.S. and Canada-a systematic review and meta-analysis","volume":"7","author":"Esmaeelzadeh","year":"2018","journal-title":"J Clin Med"},{"issue":"1","key":"2023071411353519500_CIT0005","doi-asserted-by":"crossref","first-page":"6","DOI":"10.1016\/j.drugalcdep.2016.07.013","article-title":"A review of the additive health risk of cannabis and tobacco co-use","volume":"166","author":"Meier","year":"2016","journal-title":"Drug Alcohol Depend."},{"issue":"6","key":"2023071411353519500_CIT0006","doi-asserted-by":"crossref","first-page":"1093","DOI":"10.1016\/j.mcna.2022.07.010","article-title":"Marijuana and the lung: evolving understandings","volume":"106","author":"Joshi","year":"2022","journal-title":"Med Clin North Am."},{"key":"2023071411353519500_CIT0007","volume-title":"Smoking and Mental Illness among Adults in the United States.","author":"Lipari","year":"2017"},{"issue":"3","key":"2023071411353519500_CIT0008","doi-asserted-by":"crossref","first-page":"135","DOI":"10.1016\/S0893-133X(97)00113-9","article-title":"Neurobiological similarities in depression and drug dependence: a self-medication hypothesis","volume":"18","author":"Markou","year":"1998","journal-title":"Neuropsychopharmacology."},{"issue":"1\u20132","key":"2023071411353519500_CIT0009","doi-asserted-by":"crossref","first-page":"26","DOI":"10.1159\/000123119","article-title":"WHO\/ISBRA Study Group on Biological State and Trait Markers of Alcohol Use and Dependence. Tobacco smoking and depression--results from the WHO\/ISBRA study","volume":"57","author":"Wiesbeck","year":"2008","journal-title":"Neuropsychobiology."},{"key":"2023071411353519500_CIT0010","doi-asserted-by":"crossref","first-page":"37","DOI":"10.18332\/tpc\/133571","article-title":"Emotional symptoms and sensation seeking: implications for tobacco interventions for youth and young adults","volume":"7","author":"Bataineh","year":"2021","journal-title":"Tob Prev Cessat"},{"issue":"2","key":"2023071411353519500_CIT0011","doi-asserted-by":"crossref","first-page":"355","DOI":"10.1016\/S0091-3057(03)00093-5","article-title":"Increased anxiety-like behavior in adult rats exposed to nicotine as adolescents","volume":"75","author":"Slawecki","year":"2003","journal-title":"Pharmacol Biochem Behav."},{"issue":"6","key":"2023071411353519500_CIT0012","doi-asserted-by":"crossref","first-page":"1609","DOI":"10.1038\/npp.2008.220","article-title":"Nicotine exposure during adolescence induces a depression-like state in adulthood","volume":"34","author":"I\u00f1iguez","year":"2009","journal-title":"Neuropsychopharmacology."},{"key":"2023071411353519500_CIT0013","doi-asserted-by":"crossref","first-page":"124","DOI":"10.1111\/j.1360-0443.2012.04015.x","article-title":"The persistence of the association between adolescent cannabis use and common mental disorders into young adulthood","volume":"108","author":"Degenhardt","year":"2013","journal-title":"Addiction."},{"issue":"1","key":"2023071411353519500_CIT0014","doi-asserted-by":"crossref","first-page":"107","DOI":"10.1007\/s00406-018-0970-7","article-title":"Cannabis and mental illness: a review","volume":"269","author":"Lowe","year":"2019","journal-title":"Eur Arch Psychiatry Clin Neurosci."},{"key":"2023071411353519500_CIT0015","doi-asserted-by":"crossref","first-page":"225","DOI":"10.1016\/j.psychres.2017.02.027","article-title":"Cannabis use and the course and outcome of major depressive disorder: a population based longitudinal study","volume":"251","author":"Feingold","year":"2017","journal-title":"Psychiatry Res"},{"issue":"4","key":"2023071411353519500_CIT0016","doi-asserted-by":"crossref","first-page":"434","DOI":"10.1016\/j.pbb.2010.03.004","article-title":"Antidepressant-like effect of delta9-tetrahydrocannabinol and other cannabinoids isolated from Cannabis sativa L","volume":"95","author":"El-Alfy","year":"2010","journal-title":"Pharmacol Biochem Behav."},{"issue":"2","key":"2023071411353519500_CIT0017","doi-asserted-by":"crossref","first-page":"151","DOI":"10.18001\/TRS.3.2.3","article-title":"Texas Adolescent Tobacco and Marketing Surveillance system\u2019s design","volume":"3","author":"P\u00e9rez","year":"2017","journal-title":"Tob Reg Sci"},{"issue":"9","key":"2023071411353519500_CIT0018","doi-asserted-by":"crossref","first-page":"509","DOI":"10.3928\/0048-5713-20020901-06","article-title":"The PHQ-9: a new depression diagnostic and severity measure","volume":"32","author":"Kroenke","year":"2002","journal-title":"Psychiatric Annals"},{"issue":"10","key":"2023071411353519500_CIT0019","doi-asserted-by":"crossref","first-page":"1092","DOI":"10.1001\/archinte.166.10.1092","article-title":"A brief measure for assessing generalized anxiety disorder: the GAD-7","volume":"166","author":"Spitzer","year":"2006","journal-title":"Arch Intern Med."},{"key":"2023071411353519500_CIT0020","doi-asserted-by":"crossref","first-page":"238","DOI":"10.1080\/1067828X.2018.1462281","article-title":"Population-based associations among cannabis use, anxiety, and depression in Norwegian adolescents","volume":"27","author":"Kaasb\u00f8ll","year":"2018","journal-title":"J Child Adolesc Subst Abuse."},{"issue":"2","key":"2023071411353519500_CIT0021","doi-asserted-by":"crossref","first-page":"269","DOI":"10.1016\/S0006-8993(00)03227-3","article-title":"Adolescent nicotine exposure produces immediate and long-term changes in CNS noradrenergic and dopaminergic function","volume":"892","author":"Trauth","year":"2001","journal-title":"Brain Res."},{"issue":"1","key":"2023071411353519500_CIT0022","doi-asserted-by":"crossref","first-page":"180","DOI":"10.1037\/0021-843X.111.1.180","article-title":"Distress tolerance and duration of past smoking cessation attempts.","volume":"111","author":"Brown","year":"2002","journal-title":"Abnorm Psychol."},{"issue":"4","key":"2023071411353519500_CIT0023","doi-asserted-by":"crossref","first-page":"350","DOI":"10.1016\/0010-440X(90)90042-Q","article-title":"Depression and depressive symptoms in smoking cessation","volume":"31","author":"Covey","year":"1990","journal-title":"Compr Psychiatry."},{"issue":"9","key":"2023071411353519500_CIT0024","doi-asserted-by":"crossref","first-page":"929","DOI":"10.1001\/archpsyc.60.9.929","article-title":"The structure of genetic and environmental risk factors for common psychiatric and substance use disorders in men and women","volume":"60","author":"Kendler","year":"2003","journal-title":"Arch Gen Psychiatry."},{"issue":"3S","key":"2023071411353519500_CIT0025","doi-asserted-by":"crossref","first-page":"S207","DOI":"10.1037\/0278-6133.27.3(Suppl.).S207","article-title":"Depressive symptoms and cigarette smoking in twins from the National Longitudinal Study of Adolescent Health","volume":"27","author":"McCaffery","year":"2008","journal-title":"Health Psychol."},{"issue":"1","key":"2023071411353519500_CIT0026","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1080\/17450128.2013.797129","article-title":"When life is a drag: depressive symptoms associated with early adolescent smoking","volume":"9","author":"Arnold","year":"2014","journal-title":"Vulnerable Child Youth Stud"},{"issue":"1","key":"2023071411353519500_CIT0027","doi-asserted-by":"crossref","first-page":"281","DOI":"10.1038\/s41380-021-01161-7","article-title":"Age at onset of mental disorders worldwide: large-scale meta-analysis of 192 epidemiological studies","volume":"27","author":"Solmi","year":"2022","journal-title":"Mol Psychiatry."},{"issue":"3","key":"2023071411353519500_CIT0028","doi-asserted-by":"crossref","first-page":"815","DOI":"10.1017\/S0954579406060408","article-title":"Self-regulation, rumination, and vulnerability to depression in adolescent girls","volume":"18","author":"Papadakis","year":"2006","journal-title":"Dev Psychopathol."},{"key":"2023071411353519500_CIT0029","volume-title":"Indicators of Anxiety or Depression Based on Reported Frequency of Symptoms During the Last 7 Days. Household Pulse Survey.","author":"CDC, National Center for Health Statistics.","year":"2020"},{"issue":"2","key":"2023071411353519500_CIT0030","doi-asserted-by":"crossref","first-page":"266","DOI":"10.1093\/ntr\/ntac205","article-title":"Patterns in mental health symptomatology and cigarette, E-cigarette and Marijuana use among texas youth and young adults amid the COVID-19 Pandemic [published online ahead of print, 2022 Aug 26]","volume":"25","author":"Clendennen","year":"2023","journal-title":"Nicotine Tob Res."},{"issue":"32","key":"2023071411353519500_CIT0031","doi-asserted-by":"crossref","first-page":"1049","DOI":"10.15585\/mmwr.mm6932a1","article-title":"Mental health, substance use, and suicidal ideation during the COVID-19 pandemic\u2014United States, June 24\u201330, 2020","volume":"69","author":"Czeisler","year":"2020","journal-title":"Morb Mortal Wkly Rep."},{"key":"2023071411353519500_CIT0032","doi-asserted-by":"crossref","first-page":"1179173X211067439","DOI":"10.1177\/1179173X211067439","article-title":"Stress, Dependence, and COVID-19-related changes in past 30-day marijuana, electronic cigarette, and cigarette use among youth and young adults","volume":"14","author":"Clendennen","year":"2021","journal-title":"Tob Use Insights"},{"issue":"6","key":"2023071411353519500_CIT0033","doi-asserted-by":"crossref","first-page":"421","DOI":"10.1016\/S2352-4642(20)30109-7","article-title":"Mental health effects of school closures during COVID-19","volume":"4","author":"Lee","year":"2020","journal-title":"Lancet Child Adolesc Health"},{"issue":"8","key":"2023071411353519500_CIT0034","doi-asserted-by":"crossref","first-page":"634","DOI":"10.1016\/S2352-4642(20)30186-3","article-title":"The effects of social deprivation on adolescent development and mental health","volume":"4","author":"Orben","year":"2020","journal-title":"Lancet Child Adolesc Health"},{"issue":"4","key":"2023071411353519500_CIT0035","doi-asserted-by":"crossref","first-page":"400","DOI":"10.1001\/jamapediatrics.2021.5840","article-title":"School closures during social lockdown and mental health, health behaviors, and well-being among children and adolescents during the first COVID-19 wave: a systematic review","volume":"176","author":"Viner","year":"2022","journal-title":"JAMA Pediatr"}],"container-title":["Nicotine and Tobacco Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/ntr\/advance-article-pdf\/doi\/10.1093\/ntr\/ntad058\/50115718\/ntad058.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ntr\/article-pdf\/25\/8\/1455\/50882541\/ntad058.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ntr\/article-pdf\/25\/8\/1455\/50882541\/ntad058.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,7,14]],"date-time":"2023-07-14T11:36:40Z","timestamp":1689334600000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/ntr\/article\/25\/8\/1455\/7115672"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,4,12]]},"references-count":35,"journal-issue":{"issue":"8","published-online":{"date-parts":[[2023,4,12]]},"published-print":{"date-parts":[[2023,7,14]]}},"URL":"https:\/\/doi.org\/10.1093\/ntr\/ntad058","relation":{},"ISSN":["1469-994X"],"issn-type":[{"value":"1469-994X","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2023,8,1]]},"published":{"date-parts":[[2023,4,12]]}}}