Department of Epidemiology and Biostatistics, School of Public Health, Indiana UniversityBloomington, Indiana, USA.
Department of Family Medicine, College of Human Medicine, Michigan State University, East Lansing, Michigan, USA.
Subst Use Misuse. 2023;58(12):1544-1549. doi: 10.1080/10826084.2023.2231072. Epub 2023 Jul 6.
While prescription psychotherapeutic drug use (PPDU) and nicotine use pose substantial problems in isolation, they pose an increased risk in combination. This study aimed to estimate the prevalence of PPDU for young people, stratified by nicotine use status. A trend analysis was used to examine changes in PPDU and nicotine use over time. We used a cross-sectional population-based sample of young people aged 16-25 years ( = 10,454) from the National Health and Nutrition Examination Survey (NHANES, 2003-2018). For each data cycle, the prevalence of self-reported PPDU and nicotine including pain relievers, sedatives, stimulants, and tranquilizers was estimated. Using Joinpoint regression, we tested for significant changes in trends using a log-linear model and permutation test approach and produced the average data cycle percentage change (ADCPC). From 2003 to 2018, 6.7% of young people had PPDU and 27.3% used nicotine. The prevalence of cigarette smoking decreased while other nicotine product use increased (' < 0.001). Those who used nicotine were more likely to have PPDU (8.2%; 95% CI = 6.5%, 9.8%) vs. non-nicotine use (6.1%; 95% CI = 5.1%, 7.0%; = 0.01). Results indicated a decreasing trend for nicotine use (ADCPC = -3.8, 95% CI = -7.2, -0.3; = 0.04), but not for PPDU (ADCPC = 1.3; 95% CI = -4.7, 7.8; = 0.61). On further examination, opioid use decreased, sedative use remained stable, and stimulant and tranquilizer use increased over time. From 2003 to 2018, young people who used nicotine had a higher prevalence of PPDU than those who did not. Clinicians should communicate the association between nicotine use and prescription drugs when prescribing or managing young patients' medications.
虽然处方精神治疗药物使用 (PPDU) 和尼古丁使用单独存在就构成了重大问题，但它们结合在一起会增加风险。本研究旨在评估年轻人中 PPDU 的流行率，并按尼古丁使用状况进行分层。趋势分析用于检查 PPDU 和尼古丁随时间的变化。
我们使用了来自全国健康和营养检查调查 (NHANES，2003-2018 年) 的 16-25 岁年轻人的基于人群的横断面样本。对于每个数据周期，估计了自我报告的 PPDU 和尼古丁使用的流行率，包括止痛药、镇静剂、兴奋剂和安定剂。使用 Joinpoint 回归，我们使用对数线性模型和置换检验方法测试趋势变化，并生成平均数据周期百分比变化 (ADCPC)。
从 2003 年到 2018 年，6.7%的年轻人有 PPDU，27.3%使用尼古丁。吸烟的流行率下降，而其他尼古丁产品的使用增加（<0.001）。使用尼古丁的人更有可能使用 PPDU（8.2%；95%CI=6.5%，9.8%），而不是不使用尼古丁（6.1%；95%CI=5.1%，7.0%；=0.01）。结果表明，尼古丁使用呈下降趋势（ADCPC=-3.8，95%CI=-7.2，-0.3；=0.04），但 PPDU 没有（ADCPC=1.3；95%CI=-4.7，7.8；=0.61）。进一步检查发现，阿片类药物使用减少，镇静剂使用保持稳定，兴奋剂和安定剂使用随时间增加。
从 2003 年到 2018 年，使用尼古丁的年轻人中 PPDU 的流行率高于不使用尼古丁的年轻人。临床医生在为年轻患者开处方或管理药物时，应在开处方或管理药物时传达尼古丁使用与处方药之间的关联。
