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.
Similar content being viewed by others
References
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.
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.
Deal C.L.: Osteoporosis: Prevention, diagnosis, and management. Am. J. Med., 102(Suppl. 1A), 35S–39S, 1997.
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.
Breslau N.: Psychiatric comorbidity of smoking and nicotine dependence. Behav. Genet., 25, 95–101, 1995.
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.
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.
Welch S.L., Fairburn C.G.: Smoking and bulimia nervosa. Int. J. Eat. Disord., 23, 433–437, 1998.
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.
Toner B.B., Garfinkel P.E., Garner D.M.: Long-term follow-up of anorexia nervosa. Psychosom. Med., 48, 520–529, 1986.
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.
Sours J.A.: Case reports of anorexia nervosa and caffeinism. Am. J. Psychiatry, 140, 235–236, 1983.
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.
Shaul P.W., Farrell M.K., Maloney M.J.: Caffeine toxicity as a cause acute psychosis in anorexia nervosa. Pediatr., 105, 493–495, 1984.
Bulik C.M.: Drug and alcohol abuse by bulimic women and their families. Am. J. Psychiatry, 144, 1604–1606, 1987.
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.
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.
Garfinkel P.E., Moldofsky H., Garner D.: The heterogeneity of anorexia nervosa. Arch. Gent. Psychiatry, 37, 1036–1040, 1980.
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.
Beck A.T., Steer R.A.: Beck Depression Inventory. San Antonio, The Psychological Corporation, 1987.
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.
Garner D.M.: Eating Disorder Inventory-2. Odessa, Psychological Assessment Resources. Inc. Florida, 1991.
Pomerleau C.S.: Co-factors for smoking and evolutionary psychobiology. Addiction, 92, 387–408, 1997.
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.
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.
Vitousek K., Manke F.: Personality variables and disorders in anorexia nervosa and bulimia nervosa. J. Abnorm. Psychol., 103, 137–147, 1994.
Costa P.T., McCrae R.R.: NEO Personality Inventory-Revised. Odessa, Psychological Assessment Resources. Inc. Florida, 1992.
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.
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.
Stitzer M.L., Walsh S.L.: Psychostimulant abuse: The case for combined behavioral and pharmacological treatments. Pharmacol. Biochem. Behav., 57, 457–470, 1997.
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.
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.
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.
Author information
Authors and Affiliations
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.
Rights and permissions
About this article
Cite this article
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
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/BF03339762