a Department of Behavioral Sciences and Health Education, Rollins School of Public Health , Emory University , Atlanta , Georgia, USA.
Subst Use Misuse. 2019;54(8):1365-1375. doi: 10.1080/10826084.2019.1581220. Epub 2019 Apr 26.
Alcohol, cannabis, and tobacco use are prevalent in young adults and may be differentially related to psychological symptoms characterized as externalizing or internalizing.
This study examined the use of alcohol, cannabis, and various tobacco products in relation to externalizing (ADHD) versus internalizing factors (depression, anxiety), hypothesizing alcohol and cannabis use are associated with externalizing factors whereas tobacco use is related to internalizing factors.
Data from a 2-year longitudinal study of 2,397 US college students (aged 18-25) launched in 2014 were analyzed. Adult ADHD Self-Report Scale, Patient Health Questionnaire-9 item (assessing depressive symptoms), and the Zung Self-Rating Anxiety Scale scores were examined in relation to subsequent past 30-day use of alcohol, cannabis, and tobacco products (cigarettes, little cigars/cigarillos, smokeless tobacco, e-cigarettes, hookah), as well as nicotine dependence per the Hooked on Nicotine Checklist.
Participants were 20.49 (SD = 1.93) years old, 64.7% female, and 65.5% White. In multivariable analyses, greater ADHD symptoms predicted alcohol and cannabis use (p = .042 and p = .019, respectively). Cigarette and little cigar/cigarillo use were predicted by greater depressive (p = .001 and p = .002, respectively), and anxiety symptoms (p = .020 and p = .027, respectively). Nicotine dependence was correlated with greater anxiety symptoms (p = .026). Counter to hypotheses, smokeless tobacco use was predicted by greater ADHD symptoms (p = .050); neither e-cigarette nor hookah use were predicted by these psychological symptoms. Conclusions/Importance: Research examining risk factors for tobacco use must distinguish among the various tobacco products. Moreover, interventions may need to differentially target use of distinct substances, including among the range of tobacco products.
酒精、大麻和烟草在年轻人中普遍存在，并且可能与表现为外化或内化的心理症状有不同的关联。
本研究考察了酒精、大麻和各种烟草制品的使用与外化（ADHD）与内化因素（抑郁、焦虑）的关系，假设酒精和大麻的使用与外化因素有关，而烟草的使用与内化因素有关。
对 2014 年开展的一项为期 2 年、涉及 2397 名美国大学生（年龄 18-25 岁）的纵向研究数据进行了分析。使用成人 ADHD 自我报告量表、患者健康问卷-9 项（评估抑郁症状）和 Zung 自评焦虑量表评估随后过去 30 天内使用酒精、大麻和烟草制品（香烟、小雪茄/小雪茄、无烟烟草、电子烟、水烟）的情况，以及尼古丁依赖情况（尼古丁依赖检查表）。
参与者的平均年龄为 20.49 岁（标准差=1.93），64.7%为女性，65.5%为白人。在多变量分析中，更多的 ADHD 症状预测了酒精和大麻的使用（p=0.042 和 p=0.019）。香烟和小雪茄/小雪茄的使用预测了更大的抑郁症状（p=0.001 和 p=0.002）和焦虑症状（p=0.020 和 p=0.027）。尼古丁依赖与更大的焦虑症状相关（p=0.026）。与假设相反，无烟烟草的使用预测了更多的 ADHD 症状（p=0.050）；电子烟和水烟的使用均未被这些心理症状所预测。结论/意义：研究烟草使用风险因素的研究必须区分各种烟草制品。此外，干预措施可能需要针对不同的物质使用情况进行区分，包括在各种烟草制品中。
