爱沙尼亚青少年镇静剂和安定类药物滥用及相关因素：2003-2019 年横断面 ESPAD 调查结果
Tranquilisers and sedatives misuse and associated factors among adolescents in Estonia: findings from cross-sectional ESPAD surveys, 2003-2019.
机构信息
Department of Risk Behaviour Studies, National Institute for Health Development, Tallinn, Estonia
Institute of Family Medicine and Public Health, University of Tartu Faculty of Medicine, Tartu, Estonia.
出版信息
BMJ Open. 2024 May 22;14(5):e077899. doi: 10.1136/bmjopen-2023-077899.
OBJECTIVES
This study aimed to (1) to describe trends of tranquilliser and sedative (TS) misuse in Estonia during 2003-2019 and (2) to analyse the associations between TS misuse and explanatory factors (perceived access to TS, medical use of TS, family-related, friends-related, school-related factors, risk behaviour and leisure time physical activity).
DESIGN
A cross-sectional study.
SETTING
Data were collected from the European School Survey Project on Alcohol and Other Drugs (ESPAD) from 2003 to 2019 in Estonia.
PARTICIPANTS
Estonian schoolchildren aged 15-16 years old (n=11 328), 48.6% were boys.
OUTCOME MEASURES
Prevalence, crude and adjusted ORs with 95% CIs for TS misuse.
RESULTS
The prevalence of lifetime TS misuse significantly increased from 2003 (5.0% of boys and 12.6% of girls) to 2019 (11.3% and 17.5%, respectively) (p<0.001). Among boys, TS misuse increased significantly among those reporting medical use of TS from 21.1% to 41.4% in 2003-2019 (p=0.006). Medical use of TS multiplied the odds of misuse by 6.89 (95% CI 5.15 to 9.24) for boys and by 4.53 (95% CI 3.58 to 5.73) for girls. Perceived easy access to TS increased the odds of misuse by 6.57 (95% CI 4.13 to 10.46) times for boys and by 4.66 (95% CI 3.25 to 6.70) times for girls. Having many friends who misuse TS increased the odds of misuse by 3.27 (95% CI 2.16 to 4.95) times for boys and by 5.07 (95% CI 3.79 to 6.77) times for girls. Furthermore, higher odds of TS misuse were observed among adolescents who smoked cigarettes and engaged in less sports.
CONCLUSIONS
TS misuse prevalence among Estonian adolescents increased significantly from 2003 to 2019. Misuse was strongly associated with medical use, perceived easy access and friends' TS misuse. These findings emphasise the need for targeted prevention strategies, including improving prescription practices, limiting TS access and promoting healthy behaviours and positive peer relationships among adolescents.
目的
本研究旨在：(1)描述 2003 年至 2019 年期间爱沙尼亚镇静剂和安定类药物（TS）滥用的趋势；(2)分析 TS 滥用与解释因素（感知获取 TS、TS 的医疗用途、家庭相关、朋友相关、学校相关因素、风险行为和休闲时间体育活动）之间的关联。
设计
横断面研究。
地点
数据来自 2003 年至 2019 年期间爱沙尼亚欧洲学校酒精和其他药物调查项目（ESPAD）。
参与者
15-16 岁的爱沙尼亚学龄儿童（n=11328），48.6%为男性。
结果衡量
TS 滥用的终生患病率、粗比值比（OR）和 95%置信区间（CI），用于 TS 滥用。
结果
终生 TS 滥用的患病率从 2003 年（男孩 5.0%，女孩 12.6%）显著增加到 2019 年（男孩 11.3%，女孩 17.5%）（p<0.001）。在男孩中，从 2003 年至 2019 年，报告使用 TS 进行医疗治疗的男孩中 TS 滥用的比例显著增加，从 21.1%增加到 41.4%（p=0.006）。TS 的医疗用途使男孩发生滥用的几率增加了 6.89 倍（95%CI 5.15 至 9.24），使女孩发生滥用的几率增加了 4.53 倍（95%CI 3.58 至 5.73）。男孩 TS 滥用的可能性增加了 6.57 倍（95%CI 4.13 至 10.46），女孩增加了 4.66 倍（95%CI 3.25 至 6.70），感知 TS 容易获取。有许多滥用 TS 的朋友会使男孩滥用 TS 的几率增加 3.27 倍（95%CI 2.16 至 4.95），女孩增加 5.07 倍（95%CI 3.79 至 6.77）。此外，吸烟和运动较少的青少年 TS 滥用的几率更高。
结论
从 2003 年到 2019 年，爱沙尼亚青少年中 TS 滥用的流行率显著增加。滥用与医疗使用、感知易获取和朋友的 TS 滥用密切相关。这些发现强调了需要针对青少年制定有针对性的预防策略，包括改善处方实践、限制 TS 的获取以及促进青少年的健康行为和积极的同伴关系。
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