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与青少年精神和物质使用障碍住院患者的吸烟和戒烟意愿相关的因素。

Factors related to cigarette smoking and intent to quit among adolescent inpatients with psychiatric and substance use disorders.

机构信息

Department of Psychology, Fordham University, 441 E. Fordham Road, Bronx, NY, 10458, USA.

Department of Psychiatry and Human Behavior and Medicine, Division of General Internal Medicine at Rhode Island Hospital, Brown University, Providence, RI, 02912, USA.

出版信息

Drug Alcohol Depend. 2018 May 1;186:215-218. doi: 10.1016/j.drugalcdep.2018.01.030. Epub 2018 Mar 26.

Abstract

PURPOSE

Smoking behaviors and intent to quit have not been well studied among adolescent psychiatric patients. The current study examined the relationships between smoking-related variables (smoking status/heaviness and intent to quit), psychiatric diagnoses and symptomatology, and substance use among adolescents receiving psychiatric inpatient care.

METHODS

Baseline data from a randomized controlled trial, testing the effect of a brief intervention on substance use, with 151 psychiatrically hospitalized adolescents with comorbid psychiatric and substance use disorders (diagnosed using semi-structured interviews) were examined for this study.

RESULTS

Of 151 inpatients aged 13-17 years, 112 (74.2%) were smokers (self-report), of whom 59 (52.7%) expressed intent to quit within 3 months and 36 (32.1%) within 30 days. There were no differences in psychiatric diagnoses or alcohol, marijuana, or any drug use among smokers and nonsmokers. On the other hand, smokers reported significantly greater occurrences of negative consequences from alcohol use, drug use, and total substance use than nonsmokers. Separate analyses also revealed that heavier smokers reported greater negative consequences from alcohol/drug/total use. Similarly, while no difference in externalizing or internalizing symptoms was observed across smokers vs. nonsmokers, heavier smokers reported significantly more severe externalizing symptoms, but not internalizing symptoms, than lighter smokers. Intention to quit smoking did not vary as a function of psychiatric symptomatology or substance use.

CONCLUSIONS

Smoking was related to several psychiatric and substance use problems. Notably, adolescent psychiatric inpatient smokers reported intention to quit smoking regardless of psychiatric disorders, psychiatric symptom severity, or other substance use.

摘要

目的

青少年精神科患者的吸烟行为和戒烟意愿尚未得到充分研究。本研究旨在探讨吸烟相关变量(吸烟状况/吸烟量和戒烟意愿)、精神科诊断和症状与物质使用之间的关系,这些变量与接受精神科住院治疗的青少年有关。

方法

本研究对一项随机对照试验的基线数据进行了分析,该试验测试了一种简短干预对物质使用的影响,共纳入了 151 名患有共病精神和物质使用障碍的精神科住院青少年(使用半结构化访谈进行诊断)。

结果

在 151 名年龄在 13-17 岁的住院患者中,112 名(74.2%)为吸烟者(自我报告),其中 59 名(52.7%)表示在 3 个月内有戒烟意愿,36 名(32.1%)表示在 30 天内有戒烟意愿。吸烟者和不吸烟者在精神科诊断或酒精、大麻或任何药物使用方面没有差异。另一方面,吸烟者报告称,酒精使用、药物使用和总物质使用的负面后果明显多于不吸烟者。单独的分析还表明,吸烟量较大的人报告称,酒精/药物/总使用的负面后果更大。同样,尽管在吸烟者和不吸烟者之间没有观察到外显或内隐症状的差异,但吸烟量较大的人报告称,外显症状比吸烟量较小的人更严重,但内隐症状没有差异。戒烟意愿的强弱与精神症状或物质使用无关。

结论

吸烟与多种精神和物质使用问题有关。值得注意的是,青少年精神科住院吸烟者表示无论是否存在精神障碍、精神症状严重程度或其他物质使用情况,都有戒烟意愿。

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本文引用的文献

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Smoking and mental illness--breaking the link.吸烟与精神疾病——切断联系
N Engl J Med. 2011 Jul 21;365(3):196-8. doi: 10.1056/NEJMp1105248.
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Tobacco use in youth with mental illnesses.青少年精神疾病与烟草使用。
J Behav Med. 2012 Apr;35(2):139-48. doi: 10.1007/s10865-011-9336-6. Epub 2011 Apr 9.
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Intentions to quit smoking among youth in substance abuse treatment.物质滥用治疗中心青少年的戒烟意愿。
Drug Alcohol Depend. 2010 Jan 1;106(1):48-51. doi: 10.1016/j.drugalcdep.2009.07.004. Epub 2009 Aug 20.

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