From the Seattle Epidemiologic Research and Information Center, Department of Veterans Affairs Puget Sound Health Care System (ADS, KMB, AJL, CM, EJB); Department of Health Services, University of Washington (KMB, ECW, CM); Denver-Seattle Center of Innovation for Veteran-Centered and Value-Driven Care, Health Services Research and Development, VA Puget Sound Health Care System, Seattle, WA (ECW, AJL, CM); The Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD (RFA, ACR, IGJ); Division of Public Health Sciences, Fred Hutchinson Cancer Research Center (AVP, JBB); Department of Biostatistics, University of Washington (AVP); Department of Epidemiology, University of Washington School of Public Health (AJL, EJB); Department of Psychology, University of Washington, Seattle, WA (JBB); Military Population Health Directorate, Naval Health Research Center, San Diego, CA (RPR).
J Addict Med. 2018 Sep/Oct;12(5):363-372. doi: 10.1097/ADM.0000000000000421.
The aim of this study was to determine whether specific individual posttraumatic stress disorder (PTSD) symptoms or symptom clusters predict cigarette smoking initiation.
Longitudinal data from the Millennium Cohort Study were used to estimate the relative risk for smoking initiation associated with PTSD symptoms among 2 groups: (1) all individuals who initially indicated they were nonsmokers (n = 44,968, main sample) and (2) a subset of the main sample who screened positive for PTSD (n = 1622). Participants were military service members who completed triennial comprehensive surveys that included assessments of smoking and PTSD symptoms. Complementary log-log models were fit to estimate the relative risk for subsequent smoking initiation associated with each of the 17 symptoms that comprise the PTSD Checklist and 5 symptom clusters. Models were adjusted for demographics, military factors, comorbid conditions, and other PTSD symptoms or clusters.
In the main sample, no individual symptoms or clusters predicted smoking initiation. However, in the subset with PTSD, the symptoms "feeling irritable or having angry outbursts" (relative risk [RR] 1.41, 95% confidence interval [CI] 1.13-1.76) and "feeling as though your future will somehow be cut short" (RR 1.19, 95% CI 1.02-1.40) were associated with increased risk for subsequent smoking initiation.
Certain PTSD symptoms were associated with higher risk for smoking initiation among current and former service members with PTSD. These results may help identify individuals who might benefit from more intensive smoking prevention efforts included with PTSD treatment.
本研究旨在确定特定的创伤后应激障碍（PTSD）症状或症状群是否可预测吸烟的起始。
利用千禧年队列研究的纵向数据，通过两组人群来评估 PTSD 症状与吸烟起始相关的相对风险：（1）所有最初表示自己为不吸烟者的个体（n=44968，主要样本）和（2）主要样本中 PTSD 筛查阳性的个体子集（n=1622）。参与者为完成包括吸烟和 PTSD 症状评估的三年期综合调查的现役军人。互补对数几率模型用于估计与 PTSD 检查表中的 17 个症状中的每一个以及 5 个症状群相关的随后吸烟起始的相对风险。模型根据人口统计学、军事因素、合并症和其他 PTSD 症状或群进行调整。
在主要样本中，没有单个症状或症状群可预测吸烟起始。然而，在 PTSD 亚组中，“易怒或脾气爆发”（相对风险[RR]1.41，95%置信区间[CI]1.13-1.76）和“感觉你的未来将以某种方式缩短”（RR 1.19，95%CI 1.02-1.40）这两个症状与随后吸烟起始的风险增加相关。
某些 PTSD 症状与 PTSD 现役和退役军人中吸烟起始的风险增加有关。这些结果可能有助于识别可能受益于包含 PTSD 治疗的更强化吸烟预防措施的个体。
