University of Texas Health Science Center at Houston, School of Public Health, Dallas, TX, USA.
University of Texas Health Science Center at Houston (UTHealth), School of Public Health, Austin, TX, USA.
Addict Behav. 2024 Jan;148:107876. doi: 10.1016/j.addbeh.2023.107876. Epub 2023 Oct 2.
Previous research has shown important links between anxiety and the use of tobacco and cannabis. However, it remains unclear whether anxiety leads youth to start using tobacco and cannabis at an earlier age.
Data were drawn from Texas Adolescent Tobacco and Marketing Surveillance System for the years 2019-2021(Waves 9-14). Participants were in 10th-grade, 12th-grade, and two years post-high school at baseline. The outcomes were the age of first use of cigarettes, e-cigarettes, and cannabis. Interval-censoring Cox proportional hazards models were fit to examine the differences in the estimated age of initiation of tobacco and cannabis use by anxiety.
Among the 10th-grade cohort, participants with anxiety had an increased risk of an earlier age of cigarette [AHR = 2.29(1.63-3.23)], e-cigarette [AHR = 1.53(1.17-2.00)], and cannabis [AHR = 1.59(1.23-2.05)] initiation. Among the 12th-grade cohort, participants with anxiety had an increased risk of an earlier age of cigarette [AHR = 1.52(1.21-1.90), e-cigarette [1.25(1.01-1.60)] and cannabis [AHR = 1.35(1.09-1.67] initiation. Among the post-high school cohort, the only significant association found was for cannabis initiation [AHR = 1.33(1.11-1.58). Between ages 18-to-19 years in the 10th-grade cohort, and between ages 20-21 years in the 12th-grade cohort, cumulative incidence of each of the three outcomes initiation doubled among anxious youth.
This study's findings show that anxiety symptoms can increase the risk of substance use initiation at an earlier age, especially among the youngest adolescent cohort (∼15-to-16-year-olds). These findings highlight the importance of early screening and treatment of anxiety symptoms as a preventive measure to delay or prevent the onset of substance use initiation.
先前的研究表明焦虑与吸烟和使用大麻之间存在重要联系。然而，焦虑是否会导致年轻人更早开始使用烟草和大麻仍不清楚。
本研究的数据来自德克萨斯青少年烟草和营销监测系统，时间跨度为 2019 年至 2021 年（第 9 波至第 14 波）。参与者在基线时处于 10 年级、12 年级和高中毕业后两年。结果是首次使用香烟、电子烟和大麻的年龄。采用间隔 censored Cox 比例风险模型来检验焦虑对烟草和大麻使用起始年龄的差异。
在 10 年级队列中，有焦虑症的参与者吸烟[危险比 (AHR) = 2.29(1.63-3.23)]、电子烟[AHR = 1.53(1.17-2.00)]和大麻[AHR = 1.59(1.23-2.05)]的起始年龄更早的风险增加。在 12 年级队列中，有焦虑症的参与者吸烟[AHR = 1.52(1.21-1.90)]、电子烟[AHR = 1.25(1.01-1.60)]和大麻[AHR = 1.35(1.09-1.67)]的起始年龄更早。在高中毕业后队列中，唯一显著的关联是大麻的起始年龄[AHR = 1.33(1.11-1.58)]。在 10 年级队列中，年龄在 18 至 19 岁之间，在 12 年级队列中，年龄在 20 至 21 岁之间，焦虑青少年的三种结局的累积发病率均翻倍。
本研究的结果表明，焦虑症状会增加更早开始使用物质的风险，尤其是在最年轻的青少年队列（约 15 至 16 岁）中。这些发现强调了早期筛查和治疗焦虑症状作为预防措施的重要性，以延迟或预防物质使用的开始。
