Hamer Mark, Stamatakis Emmanuel, Batty G David
Department of Epidemiology and Public Health, 1-19 Torrington Pl, University College London, London WC1E 6BT, England.
Arch Gen Psychiatry. 2010 Aug;67(8):850-5. doi: 10.1001/archgenpsychiatry.2010.76. Epub 2010 Jun 7.
Secondhand smoke (SHS) exposure has been related to various somatic health outcomes, although very little is known about the association between SHS exposure and mental health.
To assess the associations between mental health and SHS exposure, which was objectively measured using the salivary cotinine level as a circulating biochemical marker.
DESIGN, SETTING, AND PARTICIPANTS: In a cross-sectional and longitudinal study, a representative sample of 5560 nonsmoking adults (mean [SD] age, 49.8 [15.4] years; 45.5% men) and 2595 smokers (mean [SD] age, 44.8 [14.8] years; 50.2% men) without history of mental illness was drawn from the 1998 and 2003 Scottish Health Survey. A priori, study participants with cotinine values of 15.00 microg/L or higher (to convert to nanomoles per liter, multiply by 5.675) were assumed to be smokers and recategorized as such in all analyses.
A score greater than 3 on the 12-item General Health Questionnaire was used as an indicator of psychological distress. Incident psychiatric hospital admissions over 6 years of follow-up were also recorded.
Psychological distress was apparent in 14.5% of the sample. In logistic regression analyses of the cross-sectional data, after adjustments for a range of covariates, high SHS exposure among nonsmokers (cotinine level >0.70 and <15.00 microg/L) was associated with higher odds of psychological distress (odds ratio = 1.49; 95% confidence interval, 1.13-1.97) in comparison with participants with cotinine levels below the limit of detection (< or = 0.05 microg/L). In prospective analyses, risk of a psychiatric hospital admission was related to high SHS exposure (multivariate adjusted hazard ratio = 2.84; 95% confidence interval, 1.07-7.59) and active smoking (multivariate adjusted hazard ratio = 3.74; 95% confidence interval, 1.55-8.98).
Exposure to SHS is associated with psychological distress and risk of future psychiatric illness in healthy adults. These concordant findings using 2 different research designs emphasize the importance of reducing SHS exposure at a population level not only for physical health but also for mental health.
二手烟暴露与多种躯体健康后果相关，然而对于二手烟暴露与心理健康之间的关联却知之甚少。
评估心理健康与二手烟暴露之间的关联，二手烟暴露通过唾液可替宁水平作为循环生化标志物进行客观测量。
设计、场所和参与者：在一项横断面和纵向研究中，从1998年和2003年苏格兰健康调查中抽取了5560名无精神疾病史的非吸烟成年人（平均[标准差]年龄，49.8[15.4]岁；45.5%为男性）和2595名吸烟者（平均[标准差]年龄，44.8[14.8]岁；50.2%为男性）作为代表性样本。预先设定，可替宁值为15.00微克/升或更高（转换为纳摩尔/升时，乘以5.675）的研究参与者被假定为吸烟者，并在所有分析中重新分类。
12项一般健康问卷得分大于3被用作心理困扰的指标。还记录了6年随访期间的精神病住院事件。
样本中有14.5%存在心理困扰。在横断面数据的逻辑回归分析中，在对一系列协变量进行调整后，与可替宁水平低于检测限（≤0.05微克/升）的参与者相比，非吸烟者中高二手烟暴露（可替宁水平>0.70且<15.00微克/升）与心理困扰的较高几率相关（优势比=1.49；95%置信区间，1.13 - 1.97）。在前瞻性分析中，精神病住院风险与高二手烟暴露（多变量调整风险比=2.84；95%置信区间，1.07 - 7.59）和主动吸烟（多变量调整风险比=3.74；95%置信区间，1.55 - 8.98）相关。
二手烟暴露与健康成年人的心理困扰和未来患精神疾病的风险相关。使用两种不同研究设计得出的这些一致发现强调了在人群层面减少二手烟暴露的重要性，这不仅关乎身体健康，也关乎心理健康。
