Department of Prevention and Community Health, George Washington University Milken Institute School of Public Health, 950 New Hampshire Avenue NW, Washington, DC 20052, United States.
Department of Prevention and Community Health, George Washington University Milken Institute School of Public Health, 950 New Hampshire Avenue NW, Washington, DC 20052, United States; Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe St., Baltimore, MD 21205, United States.
Drug Alcohol Depend. 2019 Dec 1;205:107686. doi: 10.1016/j.drugalcdep.2019.107686. Epub 2019 Oct 28.
Cigarette smoking is disproportionately high among adults with two or more psychiatric disorders (psychiatric comorbidities), yet research on non-cigarette tobacco use among this population is scant. Additionally, most studies on tobacco use this among this population rely on psychiatric diagnoses rather than individual symptoms, potentially excluding individuals with symptom-specific issues that increase their risk for tobacco use but do not meet the criteria for diagnosis. The objectives of this study were to identify unique classes of individuals based on symptoms of psychiatric disorders and to assess differences in demographic characteristics and tobacco use behaviors between classes.
This study used data from Wave 2 of the Population Assessment of Tobacco and Health Study adult dataset. Latent class analysis was used to classify individuals based on internalizing, externalizing and substance use problems. Bivariate and multivariable models examined the association between latent class membership and current use of cigarettes, cigar products, electronic nicotine delivery systems, pipe, hookah and smokeless tobacco products. Poly tobacco use was also examined.
Three latent classes were identified. The "normative" class reported low prevalence of all symptoms, the "severe internalizing and non-violent externalizing" class reported severe internalizing problems and non-violent externalizing problems and the "severe" class reported high prevalence of all symptoms. Tobacco use was highest for the "severe" class and lowest for the "normative" class across products.
Individuals in the "severe" class may be at elevated risk of tobacco-related morbidity and mortality and would likely benefit from targeted tobacco control interventions.
患有两种或两种以上精神障碍（精神共病）的成年人吸烟率不成比例地高，但针对该人群中非香烟烟草使用的研究却很少。此外，大多数针对该人群中烟草使用的研究依赖于精神科诊断，而不是个体症状，这可能会排除那些有特定症状的人，这些症状会增加他们吸烟的风险，但不符合诊断标准。本研究的目的是根据精神障碍的症状确定个体的独特类别，并评估类别之间在人口统计学特征和烟草使用行为方面的差异。
本研究使用了来自成人数据集的第二波人口评估烟草和健康研究的数据。潜在类别分析用于根据内在化、外在化和物质使用问题对个体进行分类。双变量和多变量模型检查了潜在类别成员资格与当前使用香烟、雪茄产品、电子烟、烟斗、水烟和无烟烟草产品之间的关联。还检查了多烟草使用情况。
确定了三个潜在类别。“正常”类报告了所有症状的低流行率，“严重内在化和非暴力外在化”类报告了严重的内在化问题和非暴力的外在化问题，而“严重”类报告了所有症状的高流行率。在所有产品中，“严重”类的烟草使用率最高，而“正常”类的烟草使用率最低。
“严重”类个体可能处于烟草相关发病率和死亡率的风险增加状态，可能需要针对该类别的烟草控制干预措施。
