University of Texas Health Science Center at Houston, School of Public Health, Austin, TX, USA.
University of Texas Health Science Center at Houston, School of Public Health, Austin, TX, USA.
Drug Alcohol Depend. 2023 Nov 1;252:110971. doi: 10.1016/j.drugalcdep.2023.110971. Epub 2023 Sep 22.
Studies have demonstrated important associations between depressive symptoms and tobacco and marijuana use. However, to date, it is unknown if depressive symptoms predispose youth to tobacco and marijuana use at earlier ages over time.
Data from the Texas Adolescent Tobacco and Marketing Surveillance System (TATAMS) for the years 2019-2021 (Waves 9-14) were used. Eligible samples include individuals who had never used cigarette (n=1776), e-cigarette (n=1353), or marijuana (n=1505) at basline and had complete data on covariates. Interval-censoring survival analysis was used to examine the differences in the estimated age of first use of cigarettes, e-cigarettes, and marijuana by depressive symptoms.
10th-grade cohort participants with depressive symptoms had increased risk of earlier age of first use of cigarette [AHR=1.45; 95% CI=1.02-2.04)], e-cigarette [AHR=1.65(1.27-2.15)], and marijuana [AHR=1.56(1.20-2.01)]. 12th-grade cohort participants with depressive symptoms had increased risk of earlier age of first use of cigarette [AHR=1.41(1.11-1.82), e-cigarette [AHR=1.35(1.10-1.87)] and marijuana [AHR=1.25(1.01-1.55)]. However, among the two-year post-high school cohort, depressive symptoms predicted the age of first use of marijuana only [AHR=1.34(1.13-1.60)]. Between ages 18-to-20 years, the estimated cumulative incidence of initiation almost doubled for all three products among depressive participants in 10th and 12th-grade cohorts.
Among 10th-grade, 12th-grade, and 2-year post-HS students, those with depressive symptoms initiate tobacco and marijuana use at earlier ages than peers without depressive symptoms. Early screening and management of depressive symptoms among adolescents and young adults may be a promising target for preventing or delaying the age of first use of substance use.
研究表明，抑郁症状与烟草和大麻使用之间存在重要关联。然而，迄今为止，尚不清楚抑郁症状是否会随着时间的推移导致年轻人更早地开始使用烟草和大麻。
使用 2019-2021 年德克萨斯青少年烟草和营销监测系统（TATAMS）的数据（波 9-14）。合格样本包括基线时从未使用过香烟（n=1776）、电子烟（n=1353）或大麻（n=1505）且具有完整协变量数据的个体。间隔 censoring 生存分析用于检查抑郁症状对香烟、电子烟和大麻首次使用年龄的估计差异。
有抑郁症状的 10 年级队列参与者首次使用香烟的年龄较早[风险比（AHR）=1.45；95%置信区间（CI）=1.02-2.04]、电子烟[AHR=1.65（1.27-2.15）]和大麻[AHR=1.56（1.20-2.01）]的风险增加。有抑郁症状的 12 年级队列参与者首次使用香烟的年龄较早[AHR=1.41（1.11-1.82）、电子烟[AHR=1.35（1.10-1.87）]和大麻[AHR=1.25（1.01-1.55）]的风险增加。然而，在高中毕业后两年的队列中，抑郁症状仅预测大麻首次使用的年龄[AHR=1.34（1.13-1.60）]。在 18 至 20 岁之间，在 10 年级和 12 年级队列中，有抑郁症状的参与者使用所有三种产品的估计累积发生率几乎翻了一番。
在 10 年级、12 年级和高中毕业后两年的学生中，有抑郁症状的学生比没有抑郁症状的同龄人更早开始使用烟草和大麻。对青少年和年轻成年人进行抑郁症状的早期筛查和管理可能是预防或延迟首次使用物质的有希望的目标。
