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烟草成瘾的社会药理学:对理解健康差异的启示

The Sociopharmacology of Tobacco Addiction: Implications for Understanding Health Disparities.

作者信息

Leventhal Adam M

机构信息

Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA; Department of Psychology, University of Southern California, Los Angeles, CA

出版信息

Nicotine Tob Res. 2016 Feb;18(2):110-21. doi: 10.1093/ntr/ntv084. Epub 2015 Apr 18.

Abstract

Efforts to reduce the public health burden of tobacco use have not equally benefited all members of society, leading to disparities in tobacco use as a function of ethnicity/race, socioeconomic position, physical/behavioral comorbidity, and other factors. Although multilevel transdisciplinary models are needed to comprehensively understand sources of tobacco-related health disparities (TRHD), the incorporation of psychopharmacology into TRHD research is rare. Similarly, psychopharmacology researchers have often overlooked the societal context in which tobacco is consumed. In an effort to facilitate transdisciplinary research agendas for studying TRHD and the psychopharmacology of tobacco use, this article introduces a novel paradigm, called "sociopharmacology." Sociopharmacology is a platform for investigating how contextual factors amplify psychopharmacological determinants of smoking to disproportionately enhance vulnerability to smoking in populations subject to TRHD. The overall goal of sociopharmacology is to identify proximal person-level psychopharmacological mechanisms that channel distal societal-level influences on TRHD. In this article I describe: (1) sociopharmacology's overarching methodology and theoretical framework; (2) example models that apply sociopharmacology to understand mechanisms underlying TRHD; (3) how sociopharmacological approaches may enhance the public health impact of basic research on the psychopharmacology of tobacco use; and (4) how understanding sociopharmacological mechanisms of TRHD might ultimately translate into interventions that reduce TRHD.

摘要

为减轻烟草使用对公众健康造成的负担所做的努力,并未使社会所有成员均平等受益,这导致烟草使用情况因种族/民族、社会经济地位、身体/行为合并症及其他因素而存在差异。尽管需要采用多层次跨学科模型来全面理解烟草相关健康差异(TRHD)的根源,但将心理药理学纳入TRHD研究的情况却很少见。同样,心理药理学研究人员也常常忽视烟草消费的社会背景。为推动研究TRHD及烟草使用心理药理学的跨学科研究议程,本文引入了一种名为“社会药理学”的新范式。社会药理学是一个平台,用于研究背景因素如何放大吸烟的心理药理学决定因素,从而使受TRHD影响的人群更容易吸烟。社会药理学的总体目标是确定近端个人层面的心理药理学机制,这些机制传导远端社会层面因素对TRHD的影响。在本文中,我将描述:(1)社会药理学的总体方法和理论框架;(2)应用社会药理学来理解TRHD潜在机制的示例模型;(3)社会药理学方法如何增强烟草使用心理药理学基础研究对公共卫生的影响;以及(4)理解TRHD的社会药理学机制最终如何转化为减少TRHD的干预措施。

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