Patton George C, Coffey Carolyn, Carlin John B, Sawyer Susan M, Wakefield Melanie
Centre for Adolescent Health, Royal Children's Hospital, Murdoch Childrens Research Institute, Parkville, Victoria, Australia.
J Adolesc Health. 2006 Aug;39(2):214-20. doi: 10.1016/j.jadohealth.2005.11.027.
Most outcome studies of adolescent smokers have focused on tobacco use in the short term. Few have reported on the health of adolescent smokers as they reach young adulthood.
The design was a 10-year, eight-wave cohort study of a state-wide community sample of 1943 participants in Victoria, Australia. Participants were initially aged 14 to 15 years. Tobacco use was assessed with self-reported frequency of use and a seven-day retrospective diary. The Fagerstrom Test for Nicotine Dependence was used to define nicotine dependence in young adulthood. A computerized interview assessment was used during the teens and in young adulthood.
Former daily smokers in adolescence accounted for most cases of nicotine dependence and high-dose (10+ cigarettes per day) smoking in young adulthood. Other substance abuse and psychiatric morbidity in young adulthood were also markedly elevated in this group. This was most clearly evident for cannabis dependence, where close to two-thirds of all cases were formerly daily tobacco smokers. Male smokers were more likely to continue as young adults. Persistent symptoms of depression and anxiety during the teens predicted progression to nicotine dependence, as did having a parent smoking daily.
The poor health outcomes of daily adolescent smokers as they reach young adulthood provide a rationale for greater tobacco control initiatives directed at early users. Clinical interventions might usefully consider factors such as psychiatric morbidity and parental smoking.
大多数针对青少年吸烟者的结局研究都集中在短期吸烟行为上。很少有研究报告青少年吸烟者步入青年期后的健康状况。
本研究采用了一项为期10年、包含8次随访的队列研究，样本来自澳大利亚维多利亚州全州范围内的1943名参与者。参与者最初年龄在14至15岁之间。通过自我报告的吸烟频率和为期7天的回顾性日记来评估烟草使用情况。使用尼古丁依赖的法格斯特龙测试来定义青年期的尼古丁依赖。在青少年时期和青年期采用计算机化访谈评估。
青少年时期的既往每日吸烟者在青年期的尼古丁依赖和高剂量（每天10支及以上香烟）吸烟情况中占大多数。该组青年期的其他药物滥用和精神疾病发病率也显著升高。这在大麻依赖方面最为明显，所有病例中近三分之二是既往每日吸烟者。男性吸烟者在青年期更有可能继续吸烟。青少年时期持续存在的抑郁和焦虑症状预示着会发展为尼古丁依赖，父母每日吸烟的情况也如此。
青少年每日吸烟者步入青年期后健康状况不佳，这为针对早期使用者加强烟草控制举措提供了依据。临床干预可能需要有效考虑精神疾病发病率和父母吸烟等因素。
