An Ruopeng, Xiang Xiaoling
Department of Kinesiology and Community Health, College of Applied Health Sciences, University of Illinois at Urbana-Champaign, USA.
Feinberg School of Medicine, Northwestern University, USA.
Prev Med. 2015 Dec;81:295-302. doi: 10.1016/j.ypmed.2015.09.026. Epub 2015 Oct 5.
To examine the relationship between smoking, heavy drinking and depression among U.S. middle-aged and older adults.
Individual-level data came from 1992-2012 waves of the Health and Retirement Study. Smoking was ascertained from self-reported cigarette smoking status at the time of interview. Heavy drinking was defined as one or more drinks per day on average or four or more drinks on any occasion in the past three months for women, and two or more drinks per day on average or four or more drinks on any occasion in the past three months for men. Depression was defined as scoring three and above on the eight-item Center for Epidemiologic Studies Depression Scale. Cox proportional hazards regressions were performed to examine the relationship between smoking, heavy drinking and depression.
Compared to non-smokers, smokers free from depression and heavy drinking at baseline were 20% (95% confidence interval: 12-28%) and 34% (20-50%) more likely to develop depression and engage in heavy drinking during follow-up period, respectively. Compared to non-depressed participants, participants with depression who were nonsmokers and non-heavy drinkers at baseline were 41% (14-74%) and 18% (6-31%) more likely to smoke and engage in heavy drinking during follow-up, respectively. Compared to non-heavy drinkers, heavy drinkers who were nonsmokers at baseline were 60% (26-104%) more likely to smoke during follow-up.
Health promotion programs in midlife and older age should be mindful of the associations between smoking, heavy drinking and depression in order to improve intervention effectiveness.
研究美国中老年人群中吸烟、酗酒与抑郁症之间的关系。
个体层面的数据来自1992 - 2012年的健康与退休研究。吸烟情况通过访谈时自我报告的吸烟状态确定。酗酒定义为女性过去三个月平均每天饮酒一杯或以上，或任何一次饮酒四杯或以上；男性过去三个月平均每天饮酒两杯或以上，或任何一次饮酒四杯或以上。抑郁症定义为在流行病学研究中心抑郁量表八项条目中得分达到三分及以上。采用Cox比例风险回归分析吸烟、酗酒与抑郁症之间的关系。
与不吸烟者相比，基线时无抑郁症且不酗酒的吸烟者在随访期间患抑郁症和酗酒的可能性分别高出20%（95%置信区间：12 - 28%）和34%（20 - 50%）。与无抑郁症的参与者相比，基线时不吸烟且不酗酒的抑郁症患者在随访期间吸烟和酗酒的可能性分别高出41%（14 - 74%）和18%（6 - 31%）。与不酗酒者相比，基线时不吸烟的酗酒者在随访期间吸烟的可能性高出60%（26 - 104%）。
中老年健康促进项目应关注吸烟、酗酒与抑郁症之间的关联，以提高干预效果。
