Nelson C B, Wittchen H U
Max Planck Institute for Psychiatry, Clinical Psychology and Epidemiology Unit, Munich, Germany.
Eur Addict Res. 1998 Mar;4(1-2):42-9. doi: 10.1159/000018929.
Ths paper describes the distribution of dependence criteria and diagnoses in a sample of 14- to 24-year-olds from Munich, Germany (n = 3,021; 71% response rate), evaluates differences between nondependent and dependent smokers and examines associations of smoking with other substances, affective and anxiety disorders. Assessment was made using the M-CIDI. The lifetime prevalence of DSM-IV nicotine dependence in the total sample is 19%, rising to 52% among regular smokers. No gender differences were seen in the progression from regular smoking to nicotine dependence, although men were more likely than women to initiate regular use. Analysis of daily cigarette use identified a significant dose-response relationship with the number of endorsed DSM-IV dependence criteria with unsuccessful cut-backs being the most prevalent criterion. As compared to nondependent smokers, dependent smokers were more likely to associate negative health effects with smoking and to have a desire to change and attempt a change in their pattern of use. Regular use of nicotine was found to be significantly associated with other substance and nonsubstance disorders, although dependent regular use was more strongly associated with these disorders than nondependent regular use. These results indicate that daily smoking is a behavior which is resistant to change despite an expressed desire and repeated cut-back attempts. Although initiation of regular smoking among nonsmokers does not occur frequently after the early twenties, the risk for dependent smoking among regular users persists into adulthood and is associated with a range of mental disorders.
本文描述了来自德国慕尼黑的14至24岁样本（n = 3,021；应答率71%）中依赖标准和诊断的分布情况，评估了非依赖吸烟者和依赖吸烟者之间的差异，并研究了吸烟与其他物质、情感和焦虑障碍之间的关联。使用M-CIDI进行评估。总样本中DSM-IV尼古丁依赖的终生患病率为19%，在经常吸烟者中升至52%。从经常吸烟发展到尼古丁依赖没有发现性别差异，尽管男性比女性更有可能开始经常吸烟。对每日吸烟量的分析发现，与认可的DSM-IV依赖标准数量存在显著的剂量反应关系，其中戒烟不成功是最普遍的标准。与非依赖吸烟者相比，依赖吸烟者更有可能将负面健康影响与吸烟联系起来，并且有改变的愿望并试图改变其使用模式。发现经常使用尼古丁与其他物质和非物质障碍显著相关，尽管依赖的经常使用比非依赖的经常使用与这些障碍的关联更强。这些结果表明，尽管有改变的愿望和多次戒烟尝试，但每日吸烟是一种难以改变的行为。虽然非吸烟者在二十出头之后很少开始经常吸烟，但经常吸烟者中依赖吸烟的风险持续到成年期，并与一系列精神障碍相关。
