Indiana University School of Public Health, Department of Epidemiology & Biostatistics, 809 East 9th. Street, Bloomington, IN 47405, USA.
Indiana University School of Public Health, Department of Epidemiology & Biostatistics, 809 East 9th. Street, Bloomington, IN 47405, USA.
Drug Alcohol Depend. 2021 Nov 1;228:109095. doi: 10.1016/j.drugalcdep.2021.109095. Epub 2021 Sep 20.
Serious psychological distress (SPD) is common among adults who smoke cigarettes and among adults with substance use disorders (SUD). It is unknown whether the burden of SPD is even greater among individuals with both cigarette smoking and SUDs. This study examined the intersectionality of SPD, cigarette smoking, and SUD over time.
Data came from annual, cross-sectional, nationally representative samples of the United States (US) National Survey on Drug Use and Health (individuals age 12+). Past-month SPD prevalences were estimated each year from 2008 to 2018 for adults age 18+ with current daily, current non-daily, former, and never cigarette smoking by SUD status (combined n = 441,286). Logistic regression models examined linear time trends of SPD.
In 2018, SPD was significantly more prevalent among adults in each smoking group with SUD versus those without SUD (daily 29.1% vs. 9.0%, non-daily 23.2% vs. 8.6%, former 19.5% vs. 3.2%, never 16.4% vs. 4.3%). After adjusting for sociodemographics, SPD prevalence increased over time across smoking statuses with a larger change for persons with SUD (AOR=1.07; 95% CI: 1.06, 1.09) vs. no SUD (AOR=1.03; 95% CI: 1.02. 1.04).
SPD was more than twice as common among adults with SUD who smoke cigarettes compared to those without SUD who do not smoke cigarettes, with the highest prevalence among adults with both SUD and daily smoking. While SPD has increased over time, differences depended on SUD status beyond the effect of cigarette smoking. These results provide further evidence for treating smoking and mental health problems together.
严重心理困扰（SPD）在吸烟的成年人和有物质使用障碍（SUD）的成年人中很常见。目前尚不清楚在同时患有吸烟和 SUD 的个体中，SPD 的负担是否更大。本研究考察了 SPD、吸烟和 SUD 随时间的交叉性。
数据来自美国（美国）国家药物使用和健康调查的年度、横断面、全国代表性样本（年龄在 12 岁及以上的个人）。根据 SUD 状态（合并 n=441,286），从 2008 年到 2018 年，每年估算年龄在 18 岁及以上的当前每日、当前非每日、以前和从不吸烟的成年人过去一个月的 SPD 患病率。逻辑回归模型检查了 SPD 的线性时间趋势。
2018 年，与没有 SUD 的成年人相比，有 SUD 的每个吸烟组的成年人 SPD 患病率明显更高（每日 29.1%比 9.0%，非每日 23.2%比 8.6%，以前 19.5%比 3.2%，从不 16.4%比 4.3%）。调整社会人口统计学因素后，随着吸烟状况的变化，SPD 的患病率随时间呈上升趋势，有 SUD 的人的变化更大（OR=1.07；95%CI：1.06，1.09）比没有 SUD（OR=1.03；95%CI：1.02.1.04）。
与没有 SUD 且不吸烟的成年人相比，有 SUD 且吸烟的成年人的 SPD 患病率高出两倍多，在同时患有 SUD 和每日吸烟的成年人中患病率最高。虽然 SPD 随时间增加，但除了吸烟的影响外，差异取决于 SUD 状态。这些结果为同时治疗吸烟和心理健康问题提供了进一步的证据。
