Department of Pharmacoepidemiology, Norwegian Institute of Public Health, and Norwegian Centre for Addiction Research, University of Oslo, Norway.
Ann Epidemiol. 2010 Dec;20(12):890-7. doi: 10.1016/j.annepidem.2010.03.010. Epub 2010 Jun 2.
The aim of this study was to evaluate prospectively smoking dependence as a predictor of repeated use of prescribed opioids in non-cancer patients.
We conducted a prospective population-based study cohort of 12,848 men and 15,894 women 30-75 years of age in health surveys in Norway during 2000-2002 with repeated opioid prescriptions (12+, during 2004-2007) recorded in the Norwegian Prescription Database as the outcome measure. Information on history of smoking and potential confounders was obtained at baseline by self-administered questionnaires. For smoking, participants were divided into categories: never; previously heavy (stopped maximum of 5 years earlier; 10+ cigarettes daily); daily not heavy (1-9 cigarettes); dependent daily smokers (10+ cigarettes), and other (previously and/or not daily). Odds ratios (ORs) with 95% confidence intervals (CIs) were estimated by logistic regression.
During follow-up, 335 (1.5%) of survey participants were registered with 12+ prescriptions of opioids during the period 2004-2007. The prevalence of repeated prescription frequency of opioids was higher for men and women with a history of smoking. The adjusted OR for prescribed opioids for dependent daily smokers was 3.1 (95% CI: 2.3-4.1), for daily non-heavy smokers 1.8 (1.2-2.7), and for previous heavy smokers 1.8 (1.1-3.0), compared with never-smokers as reference.
Results of the study suggest that smoking dependence may predict more frequent use of opioids.
本研究旨在前瞻性评估吸烟依赖是否可预测非癌症患者重复使用处方类阿片的情况。
我们开展了一项前瞻性基于人群的研究，纳入了 2000-2002 年挪威健康调查中的 12848 名男性和 15894 名 30-75 岁女性作为研究对象，随访时间为 2004-2007 年，以挪威处方数据库中记录的重复处方类阿片（12+，2004-2007 年）作为结局指标。通过自填式问卷获取基线时的吸烟史和潜在混杂因素信息。根据吸烟情况，参与者被分为以下几类：从不吸烟；既往重度吸烟（停止吸烟不超过 5 年；每天 10+支香烟）；每日非重度吸烟（1-9 支香烟）；每日依赖吸烟（10+支香烟）和其他（既往和/或非每日吸烟）。通过逻辑回归估计比值比（OR）及其 95%置信区间（CI）。
在随访期间，335 名（1.5%）调查参与者在 2004-2007 年期间被登记开具了 12+次处方类阿片。有吸烟史的男性和女性重复开具处方类阿片的频率更高。与从不吸烟者相比，每日依赖吸烟的患者开具处方类阿片的调整后 OR 为 3.1（95%CI：2.3-4.1），每日非重度吸烟的 OR 为 1.8（1.2-2.7），既往重度吸烟的 OR 为 1.8（1.1-3.0）。
研究结果表明，吸烟依赖可能预测阿片类药物使用更为频繁。
