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September 1, 2004

Nicotine Dependence and WHO Mental Health Surveys

Author Affiliations

Letters Section Editor: Robert M. Golub, MD, Senior Editor.

JAMA. 2004;292(9):1021-1022. doi:10.1001/jama.292.9.1021-c

To the Editor: The recent World Health Organization (WHO)-sponsored survey of serious mental disorders reported 12-month prevalence rates of substance use disorders ranging from 0.1% to 6.4% across locales.1 Although not explicitly stated, these rates appear to exclude nicotine dependence. For example, the US 12-month prevalence rate of nicotine dependence alone ranges from 7.0% to 9.0%,2,3 yet the US 12-month prevalence rate of serious substance abuse/dependence in the WHO survey is 3.8%. Furthermore, since the current 12-month prevalence rate of tobacco use in several of the non-US countries surveyed by the WHO is 1.5 times the rates reported in the United States,4 12-month prevalence rates of nicotine dependence in non-US countries are likely to be 10.0% or more.

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