ADM smokers who are both price sensitive and see PCPs on a regular basis may have been induced to quit smoking. Additional studies using more recent data will be needed to confirm that individuals with ADM disorders are still likely to quit smoking after receiving smoking afatinib mechanism of action cessation counseling by PCPs. Our measures of smoking status were obtained by self-report which is not as accurate as biological markers such as cotinine (Burling & Burling, 2003; Perez-Stable, Benowitz, & Marin, 1995). However, prior studies have shown that self-report is a reasonable measure of smoking behavior when compared with biologic markers (Patrick et al., 1994). Since the HCC2 survey did not ask amount of cigarette consumption, we cannot ascertain whether individuals reduced their cigarette use.

However, complete cessation is a reasonable outcome since even low levels of smoking engender health risks (Pechacek & Babb, 2004). Our measure of smoking cessation intervention only measures receipt of a discussion on quitting smoking and should not be considered equivalent to receipt of a full smoking cessation intervention such as the 5 A��s (Fiore et al., 2008) or even ��Ask, Advise, Refer�� (Schroeder, 2005). However, it is encouraging to see a positive association with smoking cessation even with this lower level of intervention. Although our measure of psychosis is a lifetime and not a past year measure as the other ADM measures, neither this did result in a high proportion of individuals with psychosis in our study sample nor did this group strongly influence our findings.

Our inclusion of binge drinking and substance use in our definition of ADM disorder includes some individuals who have episodes of heavy drinking or who use drugs illicitly but without any evidence of experiencing problems resulting from such use, which defines a disorder. Unfortunately, the limits of the survey do not allow us to differentiate between individuals with these problems who do or do not have problems from such use. Future studies are needed to more definitively evaluate effects among individuals with these alcohol and substance use disorders. Our measure of binge drinking does not match the current definitions of binge drinking (five or more drinks for men, four or more drinks for women), as its threshold is at a higher level of drinks (six or more drinks regardless of gender). As a result, our measure includes those who drink more on a given Brefeldin_A occasion but may miss individuals who would currently be considered binge drinkers. Additional studies with data based on the current definition of binge drinking may be helpful in determining whether the relationship also exists for these additional binge drinkers not identified in our data.