Drug Use, Abuse, and Dependence and the Persistence of Nicotine Dependence
Drug Use, Abuse, and Dependence and the Persistence of Nicotine Dependence
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DOI：
10.1093/ntr/ntu115
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发表时间：
2014-12-01
影响因子：
4.7
通讯作者：
Bolton, James
中科院分区：
文献类型：
--
作者：
Goodwin, Renee D.;Sheffer, Christine E.;Bolton, James
非法药物使用和尼古丁依赖 (ND) 经常同时发生。然而，迄今为止，很少有研究探讨酒精和非法药物使用在 ND 持续性中的作用。本研究的目的是调查美国成年人中特定类别的药物使用、滥用和依赖与 ND 持续存在之间的关系。数据来自全国酒精及相关疾病流行病学调查，这是一项针对 34,653 名美国人的全国性调查。 2001-2002 年间接受采访并在 3 年后再次接受采访的成年人。 Logistic 回归分析用于调查第 1 波 ND 成人中各类药物使用、滥用和依赖之间的关系以及第 2 波持续性 ND 的几率。分析根据人口特征、情绪/焦虑障碍、酒精使用障碍和其他物质使用障碍的差异进行调整。终生吸毒与持续性 ND 可能性的显着增加无关。镇静剂滥用与尼古丁持续存在的几率增加相关，但在调整人口统计、情绪/焦虑和酒精使用障碍后，其他类型的药物滥用都不能预测尼古丁持续存在。所有类型的药物依赖都与 ND 的持续存在相关；阿片类药物和镇静剂依赖与持续性 ND 之间的关联最强，而在调整情绪/焦虑障碍后，大麻和可卡因依赖之间的关联不再显着。临床医生应注意评估寻求戒烟治疗的患者是否存在药物依赖和/或药物依赖史。这些数据表明，物质依赖史预示着对持久性 ND 的脆弱性增加。
Illicit drug use and nicotine dependence (ND) frequently co-occur. Yet, to date very few studies have examined the role of alcohol and illicit drug use in ND persistence. The objectives of this study were to investigate the relationships between specific classes of drug use, abuse, and dependence and the persistence of ND over time among adults in the United States.Data were drawn from the National Epidemiologic Survey on Alcohol and Related Conditions, a national survey of 34,653U.S. adults interviewed between 2001-2002 and reinterviewed 3 years later. Logistic regression analyses were used to investigate the relationships between various classes of drug use, abuse, and dependence among adults with ND at Wave 1 and the odds for persistent ND at Wave 2. Analyses were adjusted for differences in demographic characteristics, mood/anxiety disorders, alcohol use disorders, and other substance use disorders.Lifetime drug use was not associated with significantly increased likelihood for persistent ND. Sedative abuse was associated with increased odds for nicotine persistence, but no other types of drug abuse were predictive of ND persistence, after adjusting for demographics, mood/anxiety, and alcohol use disorders. All types of drug dependence were associated with persistence of ND; the strongest associations emerged between opioid and tranquilizer dependence and persistent ND, while the associations between cannabis and cocaine dependence were no longer significant after adjusting for mood/anxiety disorders.Clinicians should take care to evaluate the presence and/or history of drug dependence among patients seeking treatment for smoking cessation. These data suggest that a history of substance dependence predicts increased vulnerability to persistent ND.