Daily tobacco smoking in treatment-seeking pathological gamblers: Clinical correlates and co-occurring psychiatric disorders

Objectives: Tobacco smoking and pathologic gambling (PG) frequently co-occur. Little is known, however, about the clinical correlates and co-occurring psychiatric disorders in treatment-seeking pathologic gamblers with and without daily tobacco smoking. Methods: Among a sample of 465 consecutive treatment-seeking subjects with current Diagnostic and Statistical Manual of Mental Disorders, 4th Edition (DSM-IV) PG, those with daily tobacco smoking were compared with those without daily tobacco smoking on measures of gambling symptom severity (South Oaks Gambling Screen and the Yale Brown Obsessive Compulsive Scale Modified for Pathologic Gambling), types of gambling, social and legal problems, and co-occurring disorders. Results: Two hundred nine (44.9%) of the 465 subjects with PG reported current daily tobacco smoking. Gamblers with daily tobacco smoking as compared with those without had higher South Oaks Gambling Screen scores, had more severe Yale Brown Obsessive Compulsive Scale Modified for Pathologic Gambling behavior scores, endorsed more DSM-IV PG criteria, lost more money gambling, were more likely to engage in nonstrategic gambling, and were less likely to have a co-occurring mood disorder. Gamblers with daily tobacco smoking and a current substance use disorder reported a greater percentage of income lost to gambling during the past year. Conclusions: Daily tobacco smoking in PG is common and associated with multiple important clinical features including more severe gambling and financial problems. These findings suggest that pathologic gamblers with daily tobacco smoking might need unique or enhanced treatment strategies.