Self-rated general health is strongly associated with important health outcomes, such as mortality. Researchers studied the relationship between self-reported drug use at baseline (the start of the study) and self-rated general health 15 years later among 3124 subjects. At baseline, subjects were from 4 U.S. cities, aged 20–32 years, and reported “good” or “excellent” health.

• At baseline, 812 subjects had never used illicit drugs, 1554 had used drugs in the past but not currently, 503 used marijuana only, and 255 used hard drugs (cocaine, amphetamines, opiates).
• Hard drug use at baseline was associated with health decline (report of “fair” or “poor” health) at follow-up.
• Cigarette smoking predicted health decline, even when other factors were accounted for, and weakened the effect of hard drug use at baseline.
• Marijuana use and past drug use at baseline did not have a statistically significant association with health decline at follow-up.

Comments by Michael Levy, Ph.D.:
The most interesting finding in this study is the relationship between cigarette smoking and health decline. While most everyone knows that cigarette smoking has serious health implications and is the leading cause of preventable death in this country, many addiction treatment professionals fail to address their client’s smoking for various reasons. This study clearly demonstrates the relationship between cigarette smoking and health decline and, hopefully, this finding will reinforce the importance of addressing cigarette smoking while clients are in substance abuse treatment.

Comments by David A. Fiellin, MD, Co-Editor of Alcohol, Other Drugs, and Health: Current Evidence:
This cohort study demonstrates an association between drug use in young adulthood and a decline in self-reported health 15 years later. The investigators aptly noted that another addictive behavior, cigarette smoking, independently predicted health decline and may overshadow the effects of intermittent drug use. The study is limited by a lack of information on ongoing drug use behaviors over follow-up.