Guxens Mònica, Nebot Manel, Ariza Carles, Ochoa Darío
Servei d'Avaluació i Mètodes d'Intervenció, Agència de Salut Pública de Barcelona, España.
Gac Sanit. 2007 May-Jun;21(3):252-60. doi: 10.1157/13106811.
To determine the factors associated with the onset of cannabis use through a systematic review of cohort studies.
An internet-based search was performed using several keywords and their combinations. Original studies with longitudinal design and the onset of cannabis use as dependent variable, as well as review studies were included, published between January 1980 and May 2004. Methodology quality of the studies was assessed independently by two reviewers, according to pre-established criteria, in order to classify studies in high, mid or low quality. Agreement between reviewers was assessed through kappa coefficient.
A total of 32 relevant studies were identified, of which 13 were of higher quality. Selection bias for the inclusion of consumers at the baseline measurement and lack or insufficient adjustment for confounders were the causes of exclusion. The factors of great evidence related to the onset of cannabis use were masculine sex, consumption of tobacco or alcohol, having a problematic relationship with parents, and cannabis consumption by friends.
Results highlight the importance of different individual, family and environmental factors on the onset of cannabis use. These must be considered to properly arrange intervention programs focusing on primary prevention among teenagers.
通过对队列研究的系统评价，确定与大麻使用起始相关的因素。
使用多个关键词及其组合进行基于互联网的搜索。纳入1980年1月至2004年5月发表的、采用纵向设计且以大麻使用起始作为因变量的原创研究以及综述研究。两位评审员根据预先设定的标准独立评估研究的方法学质量，以便将研究分为高质量、中等质量或低质量。通过kappa系数评估评审员之间的一致性。
共识别出32项相关研究，其中13项质量较高。基线测量时纳入使用者的选择偏倚以及对混杂因素缺乏调整或调整不足是被排除的原因。与大麻使用起始有充分证据的相关因素为男性性别、烟草或酒精消费、与父母关系存在问题以及朋友使用大麻。
结果突出了不同个体、家庭和环境因素对大麻使用起始的重要性。在为青少年制定侧重于一级预防的干预计划时，必须考虑这些因素。
