Quality of life and risk of psychiatric disorders among regular users of alcohol, nicotine, and cannabis: An analysis of the National Epidemiological Survey on Alcohol and Related Conditions (NESARC)

J Psychiatr Res. Jul-Aug 2015;66-67:135-41. doi: 10.1016/j.jpsychires.2015.05.004. Epub 2015 May 15.


Research is limited on the effects of regular substance use on mental health-related outcomes. We used a large nationally representative survey to examine current and future quality of life and risk of psychiatric disorders among past-year regular (weekly) users of alcohol, nicotine, and cannabis. Data on psychiatric disorders and quality of life from two waves (Wave 1 N = 43,093, Wave 2 N = 34,653) of the National Epidemiological Survey on Alcohol and Related Conditions (NESARC) were used to test study aims. In cross-sectional analyses, regular nicotine and cannabis use were associated with higher rates of psychiatric disorder, though regular alcohol use was associated with lower rates of disorders. Prospective analyses found that regular nicotine use predicted onset of anxiety, depressive, and bipolar disorders. Regular alcohol use predicted lower risk of these disorders. Regular cannabis use uniquely predicted the development of bipolar disorder, panic disorder with agoraphobia, and social phobia. Lastly, regular alcohol use predicted improvements in physical and mental health-related quality of life, whereas nicotine predicted deterioration in these outcomes. Regular cannabis use predicted declines in mental, but not physical health. These data add to the literature on the relations between substance use and mental and physical health and suggest increased risk of mental health problems among regular nicotine and cannabis users and better mental and physical health among regular alcohol users. Examination of mechanisms underlying these relationships is needed.

Keywords: Alcohol; Anxiety disorder; Bipolar disorder; Cannabis; Depression; Quality of life; Tobacco.

MeSH terms

  • Alcohol-Related Disorders / epidemiology*
  • Alcohol-Related Disorders / psychology
  • Cross-Sectional Studies
  • Female
  • Humans
  • Male
  • Marijuana Abuse / epidemiology*
  • Marijuana Abuse / psychology
  • Mental Disorders / epidemiology*
  • Prospective Studies
  • Quality of Life
  • Risk
  • Tobacco Use Disorder / epidemiology*
  • Tobacco Use Disorder / psychology
  • United States / epidemiology