Case Western Reserve University Jack, Joseph and Morton Mandel School of Applied Social Sciences, United States.
Case Western Reserve University School of Medicine, Departments of Pediatrics, Psychiatry and Environmental Health Sciences, United States.
Drug Alcohol Depend. 2014 Jan 1;134:201-210. doi: 10.1016/j.drugalcdep.2013.09.031. Epub 2013 Oct 9.
Examined effects of prenatal cocaine exposure (PCE) on tobacco, alcohol, marijuana and cocaine use by age 15.
Adolescent (n=358; 183 PCE, 175 non-prenatally cocaine exposed; NCE) drug use was assessed using urine, hair, and/or blood spot samples and self-report (Youth Risk Behavior Surveillance System; YRBSS) at ages 12 and 15. Logistic regression assessed effects of PCE on drug use controlling for other drug exposures, environment and blood lead levels (BLL).
Adjusted percentages of drug use (PCE vs. NCE) were: tobacco 35% vs. 26% (p<.04), marijuana 33% vs. 23% (p<.04), alcohol 40% vs. 35% (p<.01), and any drugs 59% vs. 50% (p<.005). PCE adolescents were twice as likely to use tobacco (OR=2.02, 95% CI=1.05-3.90, p<.04), 2.2 times more likely to use alcohol (OR=2.16, 95% CI=1.21-3.87, p<.01) and 1.8 times more likely to use marijuana (OR=1.81, 95% CI=1.02-3.22, p<.04) than NCE adolescents. A race-by-cocaine-exposure interaction (p<.01) indicated PCE non-African American adolescents had greater probability of tobacco use (65%) than NCE non-African American youth (21%). PCE was associated with any drug use (OR=2.16, CI=1.26-3.69, p<.005), while higher BLL predicted alcohol use (p<.001). Violence exposure was a predictor of tobacco (p<.002), marijuana (p<.0007) and any drug (p<.04).
PCE and exposure to violence increased the likelihood of tobacco, marijuana or any drug use by age 15, while PCE and higher early BLL predicted alcohol use. Prevention efforts should target high risk groups prior to substance use initiation.
研究产前可卡因暴露（PCE）对 15 岁时烟草、酒精、大麻和可卡因使用的影响。
青少年（n=358；183 例 PCE，175 例非产前可卡因暴露；NCE）使用的毒品通过尿液、头发和/或血斑样本和自我报告（青少年风险行为监测系统；YRBS）在 12 岁和 15 岁时进行评估。使用逻辑回归评估 PCE 对药物使用的影响，同时控制其他药物暴露、环境和血铅水平（BLL）。
调整后的药物使用百分比（PCE 与 NCE）为：烟草 35%比 26%（p<.04），大麻 33%比 23%（p<.04），酒精 40%比 35%（p<.01），任何药物 59%比 50%（p<.005）。PCE 青少年使用烟草的可能性是 NCE 青少年的两倍（OR=2.02，95%CI=1.05-3.90，p<.04），使用酒精的可能性是 NCE 青少年的 2.2 倍（OR=2.16，95%CI=1.21-3.87，p<.01），使用大麻的可能性是 NCE 青少年的 1.8 倍（OR=1.81，95%CI=1.02-3.22，p<.04）。可卡因暴露的种族交互作用（p<.01）表明，PCE 非非洲裔美国青少年使用烟草的可能性（65%）高于 NCE 非非洲裔美国青少年（21%）。PCE 与任何药物使用均相关（OR=2.16，CI=1.26-3.69，p<.005），而较高的 BLL 预测酒精使用（p<.001）。暴力暴露是烟草（p<.002）、大麻（p<.0007）和任何药物（p<.04）使用的预测因素。
PCE 和暴力暴露增加了 15 岁时使用烟草、大麻或任何药物的可能性，而 PCE 和早期较高的 BLL 预测了酒精的使用。在物质使用开始之前，预防工作应该针对高风险群体。
