Stone Matthew D, Audrain-McGovern Janet, Leventhal Adam M
Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA.
Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA.
Nicotine Tob Res. 2017 Jun 1;19(6):738-742. doi: 10.1093/ntr/ntw177.
Emerging literature implicates anhedonia-diminished capacity to experience pleasure-as a maintaining factor underlying cigarette smoking in adults. The role of anhedonia in adolescent smoking uptake has largely been uninvestigated, leaving unclear whether anhedonia is associated with smoking initiation and with psychosocial determinants of susceptibility to smoking initiation that could be targeted in prevention. This study examined the association of anhedonia with smoking initiation (ever smoke: yes/no) and factors indicative of susceptibility to smoking initiation among never-smokers (smoking outcome expectancies, curiosity about smoking, and willingness and future intention to initiate smoking).
Ninth grade students enrolled in high schools in Los Angeles, CA (N = 3299; mean [SD] age = 14.1 [0.42] years) were administered in-classroom surveys of anhedonia, depression, smoking, and other characteristics.
For every 1 SD unit increase in anhedonia, there was (1) a 42% increase in odds of smoking initiation in the overall sample (odds ratio [95% CI] = 1.42 [1.30-1.56], p < .0001) and (2) higher scores on each marker of smoking initiation susceptibility in the subsample never-smokers (βs = .10-.19; ps ≤ .002). The associations remained after adjusting for demographics and major depression symptoms.
By early adolescence: (1) anhedonia is associated with smoking initiation and (2) adolescents with higher (vs. lower) anhedonia who have never tried smoking may be more susceptible to smoking initiation perhaps due to stronger prosmoking intentions or willingness to smoke. Preventive interventions that target anhedonia and smoking-related intentions warrant consideration in interventions aimed at reducing risk of smoking initiation in affectively vulnerable youth.
These data suggest that anhedonia may be useful to incorporate into theoretical models of the emotional determinants of smoking initiation risk and provide impetus for addressing anhedonia in smoking prevention efforts.
新出现的文献表明，快感缺失（体验愉悦能力下降）是成年人吸烟的一个维持因素。快感缺失在青少年吸烟起始中的作用在很大程度上尚未得到研究，这使得快感缺失是否与吸烟起始以及与吸烟起始易感性的心理社会决定因素相关联尚不清楚，而这些心理社会决定因素可能是预防工作的目标。本研究调查了快感缺失与吸烟起始（曾经吸烟：是/否）以及从不吸烟者中表明吸烟起始易感性的因素（吸烟结果预期、对吸烟的好奇心以及开始吸烟的意愿和未来意图）之间的关联。
对加利福尼亚州洛杉矶市高中的九年级学生（N = 3299；平均[标准差]年龄 = 14.1[0.42]岁）进行了关于快感缺失、抑郁、吸烟及其他特征的课堂调查。
快感缺失每增加1个标准差单位，（1）总体样本中吸烟起始的几率增加42%（优势比[95%置信区间] = 1.42[1.30 - 1.56]，p <.0001），（2）从不吸烟者子样本中每个吸烟起始易感性指标的得分更高（β值 =.10 -.19；p值 ≤.002）。在调整了人口统计学和重度抑郁症状后，这些关联仍然存在。
到青春期早期：（1）快感缺失与吸烟起始相关，（2）从未尝试吸烟的快感缺失程度较高（与较低相比）的青少年可能更容易开始吸烟，这可能是由于更强的吸烟意愿或吸烟意愿。针对快感缺失和与吸烟相关意图的预防性干预措施值得在旨在降低情感脆弱青少年吸烟起始风险的干预措施中加以考虑。
这些数据表明，快感缺失可能有助于纳入吸烟起始风险的情感决定因素理论模型，并为在吸烟预防工作中解决快感缺失问题提供动力。
