Lee Boram, Levy Douglas E, Macy Jonathan T, Elam Kit K, Bidulescu Aurelian, Seo Dong-Chul
Health Policy Research Center, Mongan Institute, Massachusetts General Hospital, Boston, MA, USA.
Tobacco Treatment and Research Center, Massachusetts General Hospital, Boston, MA, USA.
Addiction. 2022 Jun;117(6):1727-1736. doi: 10.1111/add.15758. Epub 2021 Dec 9.
To measure the prospective relationship between smoking trajectories from adolescence to young adulthood and mental health in later adulthood and test whether this relationship was mediated by concurrent co-use of alcohol and marijuana.
Longitudinal study using data drawn from rounds 1 to 18 of the National Longitudinal Survey of Youth 1997 (NLSY97), a nationally representative cohort study spanning 21 years.
United States.
The analytical sample included those who completed survey items about smoking behaviors on at least half the data collection opportunities in adolescence and young adulthood (n = 8570, 48.9% female, 66.2% white).
Mental health in adulthood was measured using the five-item Mental Health Inventory (MHI-5; range = 0-100) at round 18. Seven trajectories of smoking from adolescence to young adulthood were identified by group-based multi-trajectory modeling, using data over 11 years from rounds 1 to 11.
Late-onset moderate smokers [β = -1.95, 95% confidence interval (CI) = -3.61 to -0.29], late-onset accelerated smokers (β = -2.53, 95% CI = -4.28 to -0.78), early-onset heavy smokers (β = -3.72, 95% CI = -5.59 to -1.85) and early-onset moderate smokers (β = -2.66, 95% CI = -4.48 to -0.84) showed poorer regression-adjusted mean MHI-5 scores in later adulthood than stable abstainers, even after controlling for baseline mental health and covariates. Whether or not a difference in MHI-5 scores was present between quitters and stable abstainers was inconclusive. The concurrent co-use of alcohol and marijuana in young adulthood significantly mediated the relationship between smoking trajectory and mental health.
Continued smoking, especially early-onset and heavy smoking from adolescence to young adulthood, appears to increase the risk of poor mental health later in mid-adulthood, and quitting smoking in young adulthood may mitigate such risk even among early-onset smokers. Mediation analyses underscore the role of using multiple substances in this pathway.
测量从青春期到青年期的吸烟轨迹与成年后期心理健康之间的前瞻性关系，并检验这种关系是否由同时使用酒精和大麻介导。
纵向研究，使用从1997年全国青年纵向调查（NLSY97）的第1轮至第18轮抽取的数据，这是一项跨越21年的全国代表性队列研究。
美国。
分析样本包括那些在青春期和青年期至少一半的数据收集机会中完成了关于吸烟行为调查项目的人（n = 8570，48.9%为女性，66.2%为白人）。
在第18轮使用五项心理健康量表（MHI-5；范围 = 0 - 100）测量成年期的心理健康。通过基于群体的多轨迹建模，使用第1轮至第11轮11年的数据，确定了从青春期到青年期的七种吸烟轨迹。
迟发性中度吸烟者[β = -1.95，95%置信区间（CI）= -3.61至 -0.29]、迟发性加速吸烟者（β = -2.53，95% CI = -4.28至 -0.78）、早发性重度吸烟者（β = -3.72，95% CI = -5.59至 -1.85）和早发性中度吸烟者（β = -2.66，95% CI = -4.48至 -0.84）在成年后期的回归调整后平均MHI-5得分比稳定戒烟者差，即使在控制了基线心理健康和协变量之后。戒烟者和稳定戒烟者之间MHI-5得分是否存在差异尚无定论。青年期同时使用酒精和大麻显著介导了吸烟轨迹与心理健康之间的关系。
持续吸烟，尤其是从青春期到青年期的早发性和重度吸烟，似乎会增加成年中期后期心理健康不佳的风险，而在青年期戒烟可能会降低这种风险，即使是早发性吸烟者。中介分析强调了在这条途径中使用多种物质的作用。
