Airagnes Guillaume, Sánchez-Rico Marina, Deguilhem Amélia, Blanco Carlos, Olfson Mark, Ouazana Vedrines Charles, Lemogne Cédric, Limosin Frédéric, Hoertel Nicolas
Department of Psychiatry and Addictology, AP-HP.Centre-Université Paris Cité, Paris, France.
Université Paris Cité, Faculté de Santé, UFR de Médecine, Paris, France.
Mol Psychiatry. 2025 Mar;30(3):1080-1088. doi: 10.1038/s41380-024-02748-6. Epub 2024 Sep 11.
We examined the prospective associations between nicotine dependence and the likelihood of psychiatric and substance use disorders in the general adult population. Participants came from a nationally representative sample of US adults aged 18 years or older, who were interviewed 3 years apart in the National Epidemiologic Survey on Alcohol and Related Conditions (Wave 1, 2001-2002; Wave 2, 2004-2005). The primary analyses were limited to 32,671 respondents (13,751 male (47.9% weighted); mean age of 45 years (SD = 0.18)) who were interviewed in both waves. We used multiple regression and propensity score matching (PSM) to estimate the strength of independent associations between nicotine dependence related to the use of tobacco products at Wave 1 and incident psychiatric disorders at Wave 2. Psychiatric disorders were measured with a structured interview (Alcohol Use Disorder and Associated Disabilities Interview Schedule-DSM-IV). All analyses adjusted for multiple potential confounders, including childhood (family history of substance use disorders, parental loss, vulnerable family environment), early-adolescence (self-esteem, social deviance, conduct disorder), late-adolescence (education, personality and psychiatric disorders), adulthood (divorce, stressful life events, social deviance, quality of life, history of alcohol or other substance use disorder), and sociodemographic factors. Multiple regression analysis and PSM converged in indicating that nicotine dependence was associated with significantly increased incidence of any psychiatric disorder (OR = 1.39(95%CI:1.20;1.60)), including substance use disorders (OR = 1.91(95%CI:1.47;2.47)), and anxiety disorders (OR = 1.31(95%CI:1.06;1.62)). Population Attributable Risk Proportions were substantial, ranging from 12.5%(95%CI:8.10;17.0) for any psychiatric disorder to 33.3%(95%CI:18.7;48.0) for any other drug use disorder. Supplementary analyses also indicated significant associations between nicotine dependence and persistence of psychiatric and substance use disorders among patients having a disorder at Wave 1. In the general adult population, nicotine dependence is associated with an increased likelihood for several psychiatric and substance use disorders. Given its high prevalence, these findings have important public health implications.
我们研究了普通成年人群中尼古丁依赖与精神疾病和物质使用障碍发生可能性之间的前瞻性关联。参与者来自美国18岁及以上成年人的全国代表性样本，他们在全国酒精及相关疾病流行病学调查中每隔3年接受一次访谈（第一波，2001 - 2002年；第二波，2004 - 2005年）。主要分析限于32671名受访者（13751名男性（加权占比47.9%）；平均年龄45岁（标准差 = 0.18）），他们在两波调查中均接受了访谈。我们使用多元回归和倾向得分匹配（PSM）来估计第一波中与烟草制品使用相关的尼古丁依赖与第二波中发生的精神疾病之间独立关联的强度。精神疾病通过结构化访谈（酒精使用障碍及相关残疾访谈时间表 - DSM - IV）进行测量。所有分析都对多个潜在混杂因素进行了调整，包括童年期（物质使用障碍家族史、父母离世、脆弱的家庭环境）、青春期早期（自尊、社会偏差、品行障碍）、青春期晚期（教育、个性和精神疾病）、成年期（离婚、应激性生活事件、社会偏差、生活质量、酒精或其他物质使用障碍史）以及社会人口学因素。多元回归分析和PSM均表明，尼古丁依赖与任何精神疾病（比值比 = 1.39（95%置信区间：1.20；1.60））的发病率显著增加相关，包括物质使用障碍（比值比 = 1.91（95%置信区间：1.47；2.47））和焦虑障碍（比值比 = 1.31（95%置信区间：1.06；1.62））。人群归因风险比例相当大，从任何精神疾病的12.5%（95%置信区间：8.10；17.0）到任何其他药物使用障碍的33.3%（95%置信区间：18.7；48.0）不等。补充分析还表明，在第一波患有疾病的患者中，尼古丁依赖与精神疾病和物质使用障碍的持续存在之间存在显著关联。在普通成年人群中，尼古丁依赖与几种精神疾病和物质使用障碍的发生可能性增加相关。鉴于其高患病率，这些发现具有重要的公共卫生意义。
