Early course of nicotine dependence in adolescent smokers.
Early course of nicotine dependence in adolescent smokers.
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DOI：
10.1542/peds.2009-0238
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发表时间：
2010-06
期刊：
影响因子：
8
通讯作者：
Difranza JR
中科院分区：
文献类型：
--
作者：
Doubeni CA;Reed G;Difranza JR
目的是描述尼古丁依赖的早期过程。在一项为期4年（2002-2006）的前瞻性研究中，通过11次个人访谈收集了1246名六年级学生的数据。使用尼古丁上瘾检查表监测受试者的10种依赖症状。使用交叉滞后分析检验了依赖程度（症状数）与吸烟频率之间的双向前瞻性关系。在370名吸过烟的受试者中，62%的人每月至少吸一次烟，53%的人有依赖症状，40%的人有升级到每天吸烟的经历。吸烟频率预测了下次访谈时依赖症状的数量，而症状的数量预测了观察到的吸烟频率上升。每月吸烟是症状发展的一个重要危险因素（校正风险比：9.9[95%可信区间：6.6-14.8]）。强烈的吸烟欲望是最常见的表现症状，通常随后出现尼古丁戒断症状，升级为每日吸烟，然后报告感觉上瘾或难以控制吸烟。任何依赖症状的出现都会增加每天吸烟的风险（危险比：6.81[95%可信区间：4.4 -10.5]）。非日常吸烟会引发尼古丁依赖。早期的依赖症状促进吸烟频率的上升，反过来，更频繁的吸烟加速了其他依赖症状的出现。随着这种正反馈的进展，尼古丁依赖的症状以典型的顺序出现，并有一些个体差异。儿科2010;125:1127 - 1133
The goal was to characterize the early course of nicotine dependence. Data were collected from 1246 sixth-graders in a 4-year (2002–2006) prospective study using 11 individual interviews. Subjects were monitored for 10 symptoms of dependence by using the Hooked on Nicotine Checklist. The bidirectional prospective relationship between the intensity of dependence (number of symptoms) and smoking frequency was examined by using cross-lagged analyses. Of the 370 subjects who had inhaled from a cigarette, 62% smoked at least once per month, 53% experienced dependence symptoms, and 40% experienced escalation to daily smoking. Smoking frequency predicted the number of dependence symptoms at the next interview, and the number of symptoms predicted reciprocally the observed escalation in smoking frequency. Monthly smoking was a strong risk factor for the development of symptoms (adjusted hazard ratio: 9.9 [95% confidence interval: 6.6–14.8]). A strong desire to smoke was the most common presenting symptom, typically followed by the appearance of symptoms of nicotine withdrawal, escalation to daily smoking, and then reports of feeling addicted or difficulty controlling smoking. The appearance of any dependence symptom increased the risk for daily smoking (hazard ratio: 6.81 [95% confidence interval: 4.4 –10.5]). Nondaily tobacco use triggers the emergence of nicotine dependence. Early dependence symptoms promote escalation in smoking frequency and, reciprocally, more-frequent smoking accelerates the appearance of additional symptoms of dependence. As this positive feedback progresses, the symptoms of nicotine dependence present in a typical sequence, with some individual variation. Pediatrics 2010;125:1127–1133
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影响因子：
4.2
作者：
Chassin, L;Presson, CC;Sherman, SJ
通讯作者：
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影响因子：
120.7
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影响因子：
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作者：
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影响因子：
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