Indiana University School of Public Health, Department of Epidemiology & Biostatistics, Bloomington, IN, USA.
Indiana University School of Public Health, Department of Epidemiology & Biostatistics, Bloomington, IN, USA.
Addict Behav. 2023 Dec;147:107837. doi: 10.1016/j.addbeh.2023.107837. Epub 2023 Aug 26.
The combination of opioid misuse and cigarette smoking contributes to increased morbidity and mortality compared to each substance use alone. We estimated the incidence of opioid misuse for persons who currently or formerly smoked versus never smoked.
Data came from the 2015-2020 National Surveys on Drug Use and Health cross-sectional surveys of US civilians aged 12+ (n = 315,661). Weighted opioid misuse incidence and average time between cigarette use initiation and opioid misuse initiation were calculated annually by smoking status. Logistic regression models tested time trends in incidence by smoking status.
Overall, 0.75% of persons initiated opioid misuse per year; opioid misuse incidence was 1.35% for those who currently smoked cigarettes, 0.54% for those who formerly smoked, and 0.67% for those who never smoked. For persons who currently smoked and misused opioids (1.50%), 95.08% smoked prior to opioid use. The average time between smoking followed by opioid misuse was 12.93 years and for opioid misuse followed by smoking was 4.36 years. Persons who currently smoked were more likely to initiate opioid misuse than those who had never smoked (AOR = 1.81, 95% CI: 1.60, 2.06). There was a decrease in the opioid misuse incidence over time (AOR = 0.90; 95% CI: 0.85, 0.92), which did not differ by smoking status.
Persons who currently smoked cigarettes, relative to those who never smoked, were more likely to initiate opioid misuse. As most individuals smoked before opioid misuse, it may be useful for primary prevention efforts to decrease opioid misuse initiation by focusing on smoking status.
与单独使用每种物质相比，阿片类药物滥用和吸烟的结合会导致发病率和死亡率增加。我们估计了目前或曾经吸烟与从不吸烟的人阿片类药物滥用的发生率。
数据来自 2015-2020 年美国 12 岁及以上居民（n=315661）的国家药物使用与健康横断面调查。按吸烟状况计算每年的阿片类药物滥用发生率和吸烟与阿片类药物滥用开始之间的平均时间。使用逻辑回归模型按吸烟状况测试发病率的时间趋势。
总体而言，每年有 0.75%的人开始阿片类药物滥用；目前吸烟的人阿片类药物滥用发生率为 1.35%，以前吸烟的人为 0.54%，从不吸烟的人为 0.67%。对于目前吸烟且滥用阿片类药物的人（1.50%），95.08%在使用阿片类药物之前吸烟。吸烟后紧接着滥用阿片类药物的平均时间为 12.93 年，而滥用阿片类药物后紧接着吸烟的平均时间为 4.36 年。目前吸烟的人比从未吸烟的人更有可能开始滥用阿片类药物（AOR=1.81，95%CI：1.60，2.06）。随着时间的推移，阿片类药物滥用的发生率呈下降趋势（AOR=0.90；95%CI：0.85，0.92），且与吸烟状况无关。
与从不吸烟的人相比，目前吸烟的人更有可能开始滥用阿片类药物。由于大多数人在滥用阿片类药物之前都吸烟，因此，通过关注吸烟状况，减少阿片类药物滥用的发生，可能有助于初级预防工作。
