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Aims The comorbidity of mental disorders and substance dependence is well documented, but prospective investigations in community samples are rare. This investigation examines the role of primary mental disorders as risk factors for the later onset of nicotine, alcohol and illicit drug use, abuse and dependence with abuse.

Design The National Comorbidity Survey (NCS) was a nationally representative survey of mental and substance disorders in the United States carried out in 1990–92. The NCS‐2 re‐interviewed a probability subsample of NCS respondents in 2001–03, a decade after the baseline survey.

Participants A total of 5001 NCS respondents were re‐interviewed in the NCS‐2 (87.6% of baseline sample).

Results Aggregate analyses demonstrated significant prospective risks posed by baseline mental disorders for the onset of nicotine, alcohol and illicit drug dependence with abuse over the follow‐up …