Moolchan E T, Ernst M, Henningfield J E
Intramural Research Program, National Institute on Drug Abuse, Baltimore, MD 21224, USA.
J Am Acad Child Adolesc Psychiatry. 2000 Jun;39(6):682-93. doi: 10.1097/00004583-200006000-00006.
To review current data on the tobacco epidemic in adolescents that impact treatment decisions.
Epidemiological and pharmacological data, risk factors, characteristics of nicotine use in adolescents, and treatment intervention reports from the literature are discussed.
Of students in grades 9 to 12, 42.7% have used tobacco; 75% of teenage smokers will smoke as adults. Environmental and biological factors influence adolescent smoking, including sociodevelopmental aspects of adolescence, psychiatric history, genetic background, ethnic and gender characteristics, drug effects, and regulatory factors. Criteria for nicotine dependence are currently based on the experience with adult smokers. Overall, smoking cessation treatment for adolescents has been disappointing because of low participation, high attrition, and low quit rates.
Characterization of nicotine dependence and further assessment of the safety and efficacy of pharmacological treatment interventions in adolescents are needed given the formidable challenge of the tobacco epidemic in adolescents.
回顾当前影响青少年治疗决策的烟草流行数据。
讨论来自文献的流行病学和药理学数据、危险因素、青少年尼古丁使用特征以及治疗干预报告。
9至12年级的学生中,42.7%使用过烟草;75%的青少年吸烟者成年后仍会吸烟。环境和生物因素影响青少年吸烟,包括青春期的社会发展方面、精神病史、遗传背景、种族和性别特征、药物作用以及监管因素。目前尼古丁依赖的标准基于成年吸烟者的经验。总体而言,青少年戒烟治疗令人失望,因为参与率低、流失率高且戒烟率低。
鉴于青少年烟草流行带来的巨大挑战,需要对尼古丁依赖进行特征描述,并进一步评估青少年药物治疗干预的安全性和有效性。