Baldassarri Stephen R, Kachadourian Lorig K, Esterlis Irina, Pietrzak Robert H
Department of Internal Medicine, Section of Pulmonary, Critical Care, and Sleep Medicine, Yale University School of Medicine, New Haven, CT, USA.
VA Connecticut Healthcare System, West Haven, CT, USA.
Addict Res Theory. 2020;28(2):160-164. doi: 10.1080/16066359.2019.1613523. Epub 2019 May 10.
Veterans are a unique population that may be at increased risk of tobacco use disorder and nicotine dependence (ND). We analyzed data from the National Health and Resilience in Veterans Study (NHRVS), a large nationally representative sample of US veterans, in order to more fully understand the prevalence and correlates of lifetime ND in US Veterans.
Descriptive statistics were conducted to summarize health and functioning/quality of life characteristics among veterans with and without lifetime ND. Hierarchical binary logistic regression analyses were conducted to evaluate the relationship between ND and psychiatric and physical health variables.
Compared with veterans without lifetime ND, veterans with lifetime ND were more likely to screen positive for several lifetime psychiatric disorders including current alcohol use disorder (odds ratio [OR] 2.79 [95% confidence interval [CI] 2.23, 3.49]), depression (OR 1.86 [1.38, 2.50]), and PTSD (OR 1.68 [1.14, 2.47]). From a medical standpoint, they were more likely to endorse having kidney disease (OR 4.18 [2.55, 6.86]), heart attack (OR 2.09 [1.51, 2.89]), and rheumatoid arthritis (1.90 [1.20, 3.00]) in addition to other conditions. They scored lower in overall physical functioning and higher in somatization symptoms.
Veterans with lifetime ND in the NHRVS survey were more likely to have psychiatric and medical conditions and lower physical functioning compared with Veterans without lifetime ND. Veterans with lifetime ND may therefore require a comprehensive and integrated approach to care that includes attention to co-morbid illness in addition to drug addiction.
退伍军人是一个独特的群体，可能有更高的烟草使用障碍和尼古丁依赖（ND）风险。我们分析了退伍军人健康与复原力全国研究（NHRVS）的数据，该研究是美国退伍军人具有全国代表性的大样本，目的是更全面地了解美国退伍军人终生尼古丁依赖的患病率及其相关因素。
进行描述性统计以总结有和没有终生尼古丁依赖的退伍军人的健康状况以及功能/生活质量特征。进行分层二元逻辑回归分析以评估尼古丁依赖与精神和身体健康变量之间的关系。
与没有终生尼古丁依赖的退伍军人相比，有终生尼古丁依赖的退伍军人更有可能在几种终生精神疾病筛查中呈阳性，包括当前酒精使用障碍（优势比[OR]2.79[95%置信区间[CI]2.23，3.49]）、抑郁症（OR 1.86[1.38，2.50]）和创伤后应激障碍（OR 1.68[1.14，2.47]）。从医学角度来看，除其他病症外，他们更有可能认可患有肾病（OR 4.18[2.55，6.86]）、心脏病发作（OR 2.09[1.51，2.89]）和类风湿性关节炎（1.90[1.20，3.00]）。他们在总体身体功能方面得分较低，在躯体化症状方面得分较高。
在NHRVS调查中有终生尼古丁依赖的退伍军人与没有终生尼古丁依赖的退伍军人相比，更有可能患有精神和身体疾病，身体功能也更低。因此，有终生尼古丁依赖的退伍军人可能需要一种全面综合的护理方法，除药物成瘾外，还应关注合并症。
