Furthermore, despite notable gender differences in the prevalence of alcohol and substance use disorders, which are more common among men (Conway et al., 2006), and depression, which is more common among women (Hasin et al., 2005), few studies have examined gender differences in the associations between substance use and depression. Existing studies that have stratified on gender provide some evidence that these associations are stronger among women. Specifically, Acierno et al. (2000) reported a significant association between heavy smoking and depressive disorder among female adolescents but not male adolescents. Tu et al. (2008) found that poor mental health was associated with marijuana use among adolescent females but not males; similarly, Patton et al. (2002) found that marijuana use was associated with depression both cross-sectionally and longitudinally among adolescent females but not males. Poulin et al. (2005) reported that alcohol use and smoking were associated with elevated depressive symptoms in adolescent females, but not males, whereas marijuana use was associated with depressive symptoms for both genders. In adults, the association between marijuana dependence and MDD was nearly twice as strong for
