吸烟女性中酒精及其他物质暴露妊娠风险增加：一项基于初级保健干预的二次分析
Increased risk for alcohol- and other substance-exposed pregnancies among women who smoke tobacco: A secondary analysis of a primary care-based intervention.
作者信息
Northrup Thomas F, Stotts Angela L, Fischer Stephen M, von Sternberg Kirk L, Velasquez Mary M
机构信息
Department of Family and Community Medicine, University of Texas Health Science Center at Houston, McGovern Medical School, Houston, United States.
Department of Psychiatry and Behavioral Sciences, UTHealth Houston, McGovern Medical School, Houston, United States.
出版信息
Tob Induc Dis. 2024 Jul 26;22. doi: 10.18332/tid/191107. eCollection 2024.
INTRODUCTION
Among women at risk for alcohol-exposed pregnancies (AEP), smoking tobacco may be associated with increased severity of alcohol use, and risk for tobacco-exposed and other substance-exposed pregnancies (TEPs/SEPs). Our secondary data analysis of the 'CHOICES Plus' intervention trial explored AEP and SEP risk by smoking status.
METHODS
Eligible women (N=261) were recruited from 12 primary care clinics in a public healthcare system, not pregnant, aged 18-44 years, drinking >3 drinks/day or >7 drinks/week, sexually active, and not using effective contraception. We compared women who did and did not smoke tobacco on alcohol and drug severity, and psychological distress (e.g. anxiety) at baseline.
RESULTS
Participants were primarily Hispanic (47.1%) or non-Hispanic Black (41.8%) and reported incomes <$20000/year (69.3%). Tobacco smoking prevalence was 45.2%. Compared to non-smokers, those who smoked drank more days/week (mean=3.3, SD=2.0 vs mean=2.7, SD=1.8, p<0.01), had higher alcohol use disorders identification test (AUDIT) scores (mean=12.1, SD=7.6 vs mean=9.8, SD=7.1, p<0.05), were more likely to report current drug use (66.1% vs 48.3%, p<0.01), and had a greater number of (lifetime) drugs used (mean=3.0, SD=2.0 vs mean=2.0, SD=1.5 days, p<0.0001). Also, those who smoked reported greater levels of anxiety (mean=5.9, SD=5.6 vs mean=4.5, SD=4.9, p<0.05), lower confidence to not drink (mean=2.8, SD=0.8 vs mean=3.1, SD=1.0, p<0.01), lower confidence to reduce risky drinking (mean=6.3, SD=3.1 vs mean=7.3, SD=2.8, p<0.0001), greater drinking temptations (mean=3.0, SD=0.9 vs mean=2.6, SD=0.9, p<0.01), and, yet greater readiness to reduce alcohol use (mean=6.2, SD=3.0 vs mean=5.2, SD=3.0, p<0.05).
CONCLUSIONS
Women who drink and smoke may have the highest AEP, TEP, and other SEP risk. Primary care providers should screen for alcohol and tobacco co-use and provide brief intervention and/or treatment referral.
CLINICAL TRIAL REGISTRATION
The study was registered on the official website of ClinicalTrials.gov.
IDENTIFIER
ID NCT01032772.
引言
在有酒精暴露妊娠（AEP）风险的女性中，吸烟可能与酒精使用严重程度增加以及烟草暴露妊娠（TEP）和其他物质暴露妊娠（SEP）风险相关。我们对“CHOICES Plus”干预试验进行的二次数据分析，按吸烟状况探讨了AEP和SEP风险。
方法
从一个公共医疗系统的12家初级保健诊所招募符合条件的女性（N = 261），她们未怀孕，年龄在18 - 44岁之间，每天饮酒超过3杯或每周饮酒超过7杯，有性行为且未使用有效的避孕措施。我们比较了基线时吸烟和不吸烟女性在酒精和药物严重程度以及心理困扰（如焦虑）方面的情况。
结果
参与者主要是西班牙裔（47.1%）或非西班牙裔黑人（41.8%），报告年收入低于20000美元（69.3%）。吸烟患病率为45.2%。与不吸烟者相比，吸烟者每周饮酒天数更多（平均值 = 3.3，标准差 = 2.0，而平均值 = 2.7，标准差 = 1.8，p < 0.01），酒精使用障碍识别测试（AUDIT）得分更高（平均值 = 12.1，标准差 = 7.6，而平均值 = 9.8，标准差 = 7.1，p < 0.05），更有可能报告当前使用药物（66.1%对48.3%，p < 0.01），并且使用的（终生）药物数量更多（平均值 = 3.0，标准差 = 2.0，而平均值 = 2.0，标准差 = 1.5，p < 0.0001）。此外，吸烟者报告的焦虑水平更高（平均值 = 5.9，标准差 = 5.6，而平均值 = 4.5，标准差 = 4.9，p < 0.05），戒酒信心较低（平均值 = 2.8，标准差 = 0.8，而平均值 = 3.1，标准差 = 1.0，p < 0.01），降低危险饮酒的信心较低（平均值 = 6.3，标准差 = 3.1，而平均值 = 7.3,标准差 = 2.8，p < 0.0001），饮酒诱惑更大（平均值 = 3.0，标准差 = 0.9，而平均值 = 2.6，标准差 = 0.9，p < 0.01），但减少酒精使用的意愿更强（平均值 = 6.2，标准差 = 3.0，而平均值 = 5.2，标准差 = 3.0，p < 0.05）。
结论
饮酒且吸烟的女性可能具有最高的AEP、TEP和其他SEP风险。初级保健提供者应筛查酒精和烟草共同使用情况，并提供简短干预和/或治疗转诊。
临床试验注册
该研究已在ClinicalTrials.gov官方网站注册。
标识符
ID NCT01032772。
Zotero 插件