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吸烟及戒烟对青少年吸烟者认知的影响。

Effects of smoking and smoking abstinence on cognition in adolescent tobacco smokers.

作者信息

Jacobsen Leslie K, Krystal John H, Mencl W Einar, Westerveld Michael, Frost Stephen J, Pugh Kenneth R

机构信息

Department of Psychiatry, Yale University School of Medicine, 100 York Street 2B, New Haven, CT 06511, USA.

出版信息

Biol Psychiatry. 2005 Jan 1;57(1):56-66. doi: 10.1016/j.biopsych.2004.10.022.

Abstract

BACKGROUND

In adult animals and humans, nicotine can produce short-term cognitive enhancement and, in some cases, neuroprotection. Recent work in animals, however, suggests that exposure to nicotine during adolescence might be neurotoxic. We tested for evidence of acute and chronic effects of tobacco smoking on cognition in adolescents who smoked tobacco daily and were compared with adolescent nonsmokers.

METHODS

Verbal working memory, verbal learning and memory, selective, divided, sustained attention, mood, symptoms of nicotine withdrawal, and tobacco craving were examined in 41 adolescent daily smokers and 32 nonsmokers who were similar in age, gender, and education. Analyses were controlled for general intelligence, reading achievement, parental educational attainment, baseline affective symptoms, and lifetime exposure to alcohol and cannabis.

RESULTS

In adolescent smokers, cessation of tobacco use increased tobacco craving, symptoms of nicotine withdrawal, and depressed mood. Adolescent smokers were found to have impairments in accuracy of working memory performance irrespective of recency of smoking. Performance decrements were more severe with earlier age of onset of smoking. Adolescent smokers experienced further disruption of working memory and verbal memory during smoking cessation. As a group, male smokers initiated smoking at an earlier age than female smokers and were significantly more impaired during tests of selective and divided attention than female smokers and nonsmokers.

CONCLUSIONS

Adolescent daily tobacco smokers experience acute impairments of verbal memory and working memory after smoking cessation, along with chronic decrements in cognitive performance that are consistent with preclinical evidence that neurotoxic effects of nicotine are more severe when exposure to nicotine occurs at earlier periods in development.

摘要

背景

在成年动物和人类中,尼古丁可产生短期认知增强作用,在某些情况下还具有神经保护作用。然而,近期动物研究表明,青春期接触尼古丁可能具有神经毒性。我们对每日吸烟的青少年进行了测试,以寻找吸烟对认知产生急性和慢性影响的证据,并与不吸烟的青少年进行比较。

方法

对41名每日吸烟的青少年和32名年龄、性别和教育程度相近的不吸烟者进行了言语工作记忆、言语学习与记忆、选择性、分散性、持续性注意力、情绪、尼古丁戒断症状及烟草渴望程度的检测。分析过程控制了一般智力、阅读成绩、父母教育程度、基线情感症状以及一生当中酒精和大麻的接触情况。

结果

在青少年吸烟者中,停止吸烟会增加烟草渴望、尼古丁戒断症状及情绪低落。发现青少年吸烟者无论近期是否吸烟,其工作记忆表现的准确性均受损。吸烟开始年龄越早,表现下降越严重。青少年吸烟者在戒烟期间工作记忆和言语记忆会受到进一步干扰。总体而言,男性吸烟者开始吸烟的年龄比女性吸烟者早,在选择性和分散性注意力测试中的受损程度明显高于女性吸烟者和不吸烟者。

结论

青少年每日吸烟者在戒烟后会出现言语记忆和工作记忆的急性受损,以及认知表现的慢性下降,这与临床前证据一致,即尼古丁的神经毒性作用在发育早期接触尼古丁时更为严重。

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