Redner Ryan, White Thomas J, Harder Valerie S, Higgins Stephen T
Vermont Center on Behavior and Health and Department of Psychiatry, University of Vermont.
Department of Psychiatry and Department of Psychology, University of Vermont.
Exp Clin Psychopharmacol. 2014 Aug;22(4):316-22. doi: 10.1037/a0037291. Epub 2014 Jun 30.
Smoking prevalence is unevenly distributed in the U.S. population, with those with mental illness, other substance use disorders, and lower socioeconomic status being especially vulnerable. Less research has been conducted on the association between these same vulnerabilities and smokeless tobacco (ST) use. The present study examined cigarette and ST use among adolescents and adults who met diagnostic criteria for major depressive disorder in the National Survey on Drug Use and Health (NSDUH). Utilizing the most recent (2011) NSDUH, we compared odds for current cigarette smoking and ST use among adolescents and adults meeting criteria for past-year major depressive disorder to the general population, after adjusting for potential confounding influences of sociodemographic and other substance use characteristics. Analyses were conducted to examine sex as a moderator of the relation between major depressive disorder and tobacco use. Odds for current cigarette smoking among those classified with major depressive disorder were increased among adolescents (OR = 1.33, 95% CI [1.05, 1.69], p = .021) and adults (OR = 1.70, 95% CI [1.47, 1.97], p < .0005), and odds for current ST use did not differ among adolescents (OR = 0.90, 95% CI [0.54, 1.49], p = .678) and were lower among adults (OR = 0.68, 95% CI [0.51, 0.91], p = .010). Sex was not a significant moderator in adolescents or adults. Major depressive disorder is associated with increased risk for smoking but not ST use among adolescents and adults further demonstrating heterogeneity in predictors of vulnerability to use of different tobacco products.
吸烟率在美国人口中的分布并不均匀，患有精神疾病、其他物质使用障碍以及社会经济地位较低的人群尤其容易受到影响。关于这些相同的易感性与无烟烟草（ST）使用之间的关联，所开展的研究较少。本研究在《全国药物使用和健康调查》（NSDUH）中，对符合重度抑郁症诊断标准的青少年和成年人的香烟和ST使用情况进行了调查。利用最新的（2011年）NSDUH，在调整了社会人口统计学和其他物质使用特征的潜在混杂影响后，我们将过去一年符合重度抑郁症标准的青少年和成年人中当前吸烟和使用ST的几率与普通人群进行了比较。进行分析以检验性别作为重度抑郁症与烟草使用之间关系的调节因素。在被归类为患有重度抑郁症的人群中，青少年当前吸烟的几率增加（OR = 1.33，95% CI [1.05, 1.69]，p = 0.021），成年人中也是如此（OR = 1.70，95% CI [1.47, 1.97]，p < 0.0005），而青少年当前使用ST的几率没有差异（OR = 0.90，95% CI [0.54, 1.49]，p = 0.678），成年人中则较低（OR = 0.68，95% CI [0.51, 0.91]，p = 0.010）。在青少年或成年人中，性别不是一个显著的调节因素。重度抑郁症与青少年和成年人吸烟风险增加相关，但与ST使用无关，这进一步证明了在使用不同烟草产品易感性预测因素方面存在异质性。
