From the Department of Psychiatry (MMH, PP, CMM), Yale University School of Medicine, New Haven, CT; Department of Psychiatry (SAM), Yale University School of Medicine, Substance Abuse Center - CMHC, New Haven, CT; and Women's Health Research at Yale (MMH, PP, CMM, SAM), Yale University School of Medicine, New Haven, CT.
J Addict Med. 2007 Sep;1(3):161-4. doi: 10.1097/ADM.0b013e318142d06c.
Alcohol and drug use disorders are highly comorbid with tobacco use. Given the substantial health risks associated with concurrent substance use and smoking, there is a clinical need to identify factors that confer heightened risk for their cause. This investigation examined gender-specific associations between smoking behaviors with current alcohol and drug use diagnoses. Data were derived from the National Epidemiologic Survey on Alcohol and Related Conditions (N = 42,565). Relationships between smoking status and DSM-IV current alcohol and drug use diagnoses by gender were assessed in terms of odds ratios using regressions. The presence of current alcohol or drug diagnoses increased the odds of being a daily, occasional, or former smoker, and gender was found to moderate these associations. Overall, women with a current alcohol use disorder had greater odds of being a daily or occasional smoker compared with men (odds ratio [OR], 3.52 versus 2.93; 5.22 versus 3.56). Women with a drug use diagnosis had greater odds of being a daily smoker compared with men (OR, 6.54 versus 4.63) and similar odds of being an occasional smoker (OR, 4.48 versus 4.51). The results of this study highlight gender-specific patterns of comorbidity, which may contribute to more focused primary and secondary prevention efforts.
酒精和药物使用障碍与烟草使用高度共病。鉴于同时使用物质和吸烟与大量健康风险相关，因此临床上需要确定增加其病因风险的因素。本研究考察了吸烟行为与当前酒精和药物使用诊断之间的性别特异性关联。数据来自国家酒精和相关条件流行病学调查（N=42565）。使用回归分析，根据性别评估了吸烟状况与 DSM-IV 目前的酒精和药物使用诊断之间的关系的比值比。目前的酒精或药物诊断的存在增加了成为每日、偶尔或以前吸烟者的几率，并且发现性别对此类关联具有调节作用。总体而言，与男性相比，患有当前酒精使用障碍的女性成为每日或偶尔吸烟者的几率更高（比值比[OR]，3.52 比 2.93；5.22 比 3.56）。有药物使用诊断的女性成为每日吸烟者的几率高于男性（OR，6.54 比 4.63），偶尔吸烟者的几率相似（OR，4.48 比 4.51）。这项研究的结果强调了共病的性别特异性模式，这可能有助于更有针对性的一级和二级预防工作。
