It is interesting that this association emerged, even though most participants were light drinkers. The finding that symptoms were more prevalent among the regular drinkers suggests that frequent alcohol use may be a risk factor for physical symptoms among Black smokers. Research has not examined the influence of comorbid drinking and smoking on physical health symptoms in Idelalisib cost this population. However, heavy smoking is related to greater smoking-related symptoms among alcoholics (York & Hirsch, 1995) and to smoking-related diseases such as cancer (Schlecht et al., 1999). Longitudinal evidence indicates that the frequency of alcohol use is predictive of health deterioration (Steinhausen, Eschmann, Heimgartner, & Winkler Metzke, 2008). Perceived stress and depression are related to physical health effects (e.

g., insomnia and gastrointestinal distress), irrespective of smoking status. Edwards, Hershberger, Russell, and Markert (2001) also found that physical symptoms measured by the PILL were associated with mental health and stress. Given that the overall PILL measure was significantly correlated with perceived stress and depressive symptoms, we anticipated that relationships also would exist with individual symptoms. Indeed, this was the case. However, a notable number of specific symptoms were unrelated to these psychosocial factors. Thus, we also explored relationships between psychosocial factors and categories of smoking-related symptoms. The combination of perceived stress and depressive symptoms was associated with gastrointestinal, cardiovascular, and vestibular balance, sleep, and tension symptoms.

However, independent relationships were found only between perceived stress and cardiovascular symptoms and between depressive symptoms and vestibular balance, sleep, and tension symptoms. This finding suggests that the model using the full PILL measure best captured the association between psychosocial factors and smoking-related symptoms. Because many adults will be diagnosed with a smoking-related chronic illness, evidence of early health problems is a public health concern. Previous research has found an independent association between tobacco smoking and health decline (Kertesz et al., 2007). Moreover, smoking is an important predictor of illness and death among people with ��harder�� drug dependencies (e.g., Hurt et al.

, 1996), and almost one-quarter of our participants reported being in recovery from other drug addictions. These findings should be interpreted in light of study strengths and weaknesses. Strengths of the present study are the sampling of Black smokers, a group that has been underinvestigated. This gap in the literature is Cilengitide unfortunate because Blacks suffer disproportionately from smoking-related diseases. A second strength is use of a biopsychosocial framework to examine relationships between psychosocial (e.g., depression and stress) and biological (e.g.