Susceptibility to nicotine dependence: The development and assessment of nicotine dependence in youth 2 study
Susceptibility to nicotine dependence: The development and assessment of nicotine dependence in youth 2 study
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DOI：
10.1542/peds.2007-0027
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发表时间：
2007-10-01
期刊：
影响因子：
8
通讯作者：
Wellman, Robert J.
中科院分区：
文献类型：
--
作者：
DiFranza, Joseph R.;Savageau, Judith A.;Wellman, Robert J.
目标。这项工作的目的是确定预测从第一次吸入香烟到依赖的进展的特征。我们研究了马萨诸塞州 6 个社区的 1246 名公立学校六年级学生（基线平均年龄：12.2 岁）。方法。我们进行了一项为期 4 年的前瞻性研究，进行了 11 次访谈。我们评估了 45 个风险因素，并通过《尼古丁成瘾清单》衡量了对烟草自主权的减弱，并根据《国际疾病分类》第 10 版修订版评估了烟草依赖性。使用 Cox 比例风险模型。结果。在 217 名吸过香烟的青少年中，第一次吸香烟时感到放松和情绪沮丧，预测他们会失去对烟草的自主权。烟草依赖是通过感觉放松、熟悉乔·骆驼、寻求新奇事物和抑郁情绪来预测的。结论。一旦接触尼古丁，很少有吸烟的危险因素会持续导致个体对依赖或丧失自主性的易感性差异。对第一剂尼古丁产生的放松体验是依赖和丧失自主性的最强预测因素。这种关联不能用特质焦虑或任何其他测量的心理社会因素来解释。这些结果与依赖过程是由第一剂尼古丁启动的理论相关进行讨论。
OBJECTIVES. The purpose of this work was to identify characteristics that predict progression from the first inhalation of a cigarette to dependence. We studied a cohort of 1246 public school 6th-graders in 6 Massachusetts communities ( mean age at baseline: 12.2 years).METHODS. We conducted a 4-year prospective study using 11 interviews. We assessed 45 risk factors and measured diminished autonomy over tobacco with the Hooked on Nicotine Checklist and evaluated tobacco dependence according to the International Classification of Diseases, 10th Revision. Cox proportional-hazards models were used.RESULTS. Among 217 youths who had inhaled from a cigarette, the loss of autonomy over tobacco was predicted by feeling relaxed the first time inhaling from a cigarette and depressed mood. Tobacco dependence was predicted by feeling relaxed, familiarity with Joe Camel, novelty seeking, and depressed mood.CONCLUSIONS. Once exposure to nicotine had occurred, remarkably few risk factors for smoking consistently contributed to individual differences in susceptibility to the development of dependence or loss of autonomy. An experience of relaxation in response to the first dose of nicotine was the strongest predictor of both dependence and lost autonomy. This association was not explained by trait anxiety or any of the other measured psychosocial factors. These results are discussed in relation to the theory that the process of dependence is initiated by the first dose of nicotine.