Centre de recherche du Centre Hospitalier de l'Université de Montréal, Montréal, Québec, Canada.
Department of Social and Preventive Medicine, School of Public Health, University of Montréal, Montréal, Quebec, Canada.
Am J Epidemiol. 2018 Aug 1;187(8):1670-1677. doi: 10.1093/aje/kwy045.
There may be sex differences in the response to nicotine, according to findings of studies in animals; however, sex differences in the natural course of cigarette smoking and nicotine dependence are documented in few studies. Prevalent (n = 240 girls; n = 184 boys) and incident (n = 231 girls; n = 184 boys) cigarette smokers from the Nicotine Dependence in Teens Study were followed up to 5 years after first puff, from age 12 to 18 years (1999-2005). We used Cox proportional hazards models to compare time to development of 3 cigarette-use (i.e., whole cigarette; 100 cigarettes lifetime; regular smoking), and 3 nicotine-dependence symptom (i.e., "really need a cigarette"; mentally addicted; physically addicted) milestones across sex. Girls were at higher risk than boys of attaining all milestones; hazard ratios (95% confidence intervals) ranged from 1.35 (1.06, 1.72) for 100 cigarettes lifetime to 1.74 (1.44, 2.10) for "really need a cigarette." Among nonregular smokers, 26% (8%; 43%) and 25% (6%; 44%) more girls than boys reported "really need a cigarette" 1 and 2 years, respectively, after first puff. Preventive interventions may need adjustment to incorporate these findings. Additional research should clarify the relative contribution of biological and social underpinnings of these sex differences.
根据动物研究的结果，尼古丁的反应可能存在性别差异；然而，关于吸烟和尼古丁依赖的自然病程中的性别差异在少数研究中有记录。在尼古丁依赖青少年研究中，对流行（n=240 名女孩；n=184 名男孩）和新出现的（n=231 名女孩；n=184 名男孩）吸烟者进行了随访，随访时间从首次吸烟后 5 年，年龄从 12 岁到 18 岁（1999-2005 年）。我们使用 Cox 比例风险模型比较了性别之间发展 3 个吸烟里程碑（即整支烟；一生吸 100 支烟；规律吸烟）和 3 个尼古丁依赖症状里程碑（即“真的需要一支烟”；心理依赖；身体依赖）的时间。女孩达到所有里程碑的风险高于男孩；风险比（95%置信区间）范围从一生吸 100 支烟的 1.35（1.06，1.72）到“真的需要一支烟”的 1.74（1.44，2.10）。在非规律吸烟者中，首次吸烟后 1 年和 2 年，分别有 26%（8%；43%）和 25%（6%；44%）的女孩比男孩报告“真的需要一支烟”。预防干预措施可能需要进行调整，以纳入这些发现。进一步的研究应该阐明这些性别差异的生物学和社会基础的相对贡献。
