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OBJECTIVES: This study aims to examine the (a) probability of transition between stages of alcohol involvement and (b) influence of tobacco use and nicotine dependence on transitions. METHODS: Data came from Waves 1 and 2 of the National Epidemiologic Survey on Alcohol and Related Conditions. Latent transition analysis estimated the probability of transitioning between stages of alcohol involvement across waves and the impact of tobacco use and nicotine dependence at Wave 1 on transitions. RESULTS: Males reporting current tobacco use but no dependence at Wave 1 were more likely to progress from No Problems to Moderate Problems (adjusted odds ratio [aOR] = 1.79; 95% confidence interval [CI] [1.44, 2.22]) and from No Problems to Severe Problems (aOR = 2.44; 95% CI [1.25, 4.77]) than nontobacco users. Females reporting current tobacco use but no dependence were more likely to progress from No Problems to Moderate Problems (aOR = 2.00; 95% CI [1.37, 2.94]) and from No Problems to Severe Problems (aOR = 2.87; 95% CI [1.34, 6.13]). Females reporting current tobacco use and dependence were more likely than females not using tobacco to transition from Moderate to No Problems (aOR = 2.10; 95% CI [1.04, 4.22]). CONCLUSIONS: Results suggest that tobacco use is a preceding correlate of progression in alcohol involvement among males and females. Among females, tobacco use and nicotine dependence are also related to alcohol involvement recovery.

This chapter explores the role of stress in the conduct of both public mental health research and practice. It begins with a discussion of the leading definitions and theories of stress proposed in relation to the experience of mental problems, followed by an examination of the multiple perspectives related to the measurement and study of stress. Given the ubiquitous nature of stress and its association with developmental challenges, this review is couched within a broader life course perspective. This perspective highlights the significance of both human development and the social context in examining the link between stress and mental health problems. The chapter identifies a range of developmental stressors spanning different life stages and describes their effects on mental health and adjustment problems.