McKelvey Karma L, Ramo Danielle E, Delucchi Kevin, Rubinstein Mark L
Center for Tobacco Control Research and Education, University of California, San Francisco, 530 Parnassus Avenue, Suite 366, San Francisco, CA 94143, USA.
Center for Tobacco Control Research and Education, University of California, San Francisco, 530 Parnassus Avenue, Suite 366, San Francisco, CA 94143, USA; Department of Psychiatry, University of California, San Francisco, 401 Parnassus Avenue, Box TRC 0984, San Francisco, CA 94143, USA.
Addict Behav. 2017 Mar;66:145-150. doi: 10.1016/j.addbeh.2016.11.017. Epub 2016 Nov 18.
Adolescent smokers are at increased risk for polydrug use, which is associated with more consequences than use of a single drug. Here we classified subgroups of polydrug use among urban adolescent cigarette-smokers; described the sociodemographic, smoking, and depression correlates; and identified three-year outcomes associated with subgroup membership.
Adolescent cigarette smokers (N=176; M=16.1; 35% male; 27% white) completed surveys assessing drug use, smoking characteristics, demographics, and depressive symptoms at baseline and 12, 24, and 36months follow-up.
Almost all participants (96%) reported using, on average, two (SD=0.97) substances (including other tobacco products) in addition to cigarettes. Latent class analysis revealed two distinct classes of polydrug users. "Limited Range Use" (84%) class members reported current use of other tobacco, alcohol, and marijuana, as did "Extended Range Use" class members (16%) who also reported current use of "harder drugs" (i.e., cocaine/crack, hallucinogens, ecstasy, and misused prescriptions). The classes did not differ on demographics or baseline likelihood of marijuana (χ=0.25; p<0.62) or alcohol use (χ=3.3; p<0.07). At baseline, a larger proportion of Extended Range Use class members reported both smoking the entire cigarette and symptoms of clinical depression. Extended Range Use class membership at baseline predicted higher mean depression scores at 24 and 36months.
Adolescent cigarette-smokers who reported extended range use (18%) also reported symptoms of clinical depression at baseline and follow-up. These findings indicate a need for early monitoring of depression symptoms and prevention and cessation interventions targeting this high-risk group.
青少年吸烟者使用多种药物的风险增加，与单一药物使用相比，使用多种药物会带来更多后果。在此，我们对城市青少年吸烟者中多种药物使用的亚组进行了分类；描述了社会人口统计学、吸烟和抑郁相关因素；并确定了与亚组成员身份相关的三年结局。
青少年吸烟者（N = 176；平均年龄16.1岁；35%为男性；27%为白人）在基线以及随访12个月、24个月和36个月时完成了评估药物使用、吸烟特征、人口统计学和抑郁症状的调查。
几乎所有参与者（96%）报告除香烟外平均还使用两种（标准差 = 0.97）物质（包括其他烟草制品）。潜在类别分析揭示了两种不同的多种药物使用者类别。“有限范围使用”（84%）类别的成员报告目前使用其他烟草、酒精和大麻，“扩展范围使用”（16%）类别的成员也是如此，他们还报告目前使用“更烈性药物”（即可卡因/快克、致幻剂、摇头丸和滥用处方药）。这两类在人口统计学或大麻（χ = 0.25；p < 0.62）或酒精使用（χ = 3.3；p < 0.07）的基线可能性方面没有差异。在基线时，扩展范围使用类别中有更大比例的成员报告整支吸烟以及临床抑郁症状。基线时属于扩展范围使用类别可预测在24个月和36个月时更高的平均抑郁评分。
报告扩展范围使用（18%）的青少年吸烟者在基线和随访时也报告有临床抑郁症状。这些发现表明需要对抑郁症状进行早期监测，并针对这一高危群体开展预防和戒烟干预。
