Early Smoking Onset and Risk for Subsequent Nicotine Dependence: A Monozygotic Co-Twin Control Study
Early Smoking Onset and Risk for Subsequent Nicotine Dependence: A Monozygotic Co-Twin Control Study
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DOI：
10.1176/appi.ajp.2012.12030321
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发表时间：
2013-04-01
影响因子：
17.7
通讯作者：
Chen, Xianging
中科院分区：
文献类型：
--
作者：
Kendler, Kenneth S.;Myers, John;Chen, Xianging
目的：早发规律吸烟与日后尼古丁依赖的风险增加有关。这种关联是否是因果关系是未知的，并具有实质性的公共政策implications.Method：作者采用了同卵双胞胎对照研究设计。从弗吉尼亚州精神病和物质使用障碍的成人双胞胎研究中选择了两对在经常吸烟开始时年龄不一致的人。尼古丁依赖性测定的Fagerstrom测试尼古丁依赖性和水平的craving.Results：作者确定了175名男性和69名女性-女性同卵双胞胎对谁不同，至少2年的年龄在发病时经常吸烟。在他们吸烟最严重的时期，较早开始吸烟的双胞胎在男性-男性（科恩d=0.20）和女性-女性双胞胎（d=0.26）中的Fagerstrom测试得分显着较高。两组中早发性成员在不能吸烟时对香烟的渴望也较高（男性对，d=0.38;女性对，d=0.25）。早发性吸烟双胞胎没有区别泡沫晚发性双胞胎在酒精或大麻滥用或依赖的症状，目前的酒精使用，或最大水平的大麻，镇静剂，兴奋剂，或cocaine use.Conclusions：控制遗传和家庭环境的影响，年龄在发病时经常吸烟预测尼古丁依赖的水平。与动物文献一致，这些发现表明，在人类中，早期尼古丁暴露直接增加了后期尼古丁依赖的水平。这些结果应在同卵双生设计的方法优势和局限性的背景下进行解释。(Am J Psychiatry 2013; 170：403-413）
Objective: Early onset of regular smoking is associated with an elevated risk for later nicotine dependence. Whether or not this association is causal is unknown and has substantial public policy implications.Method: The authors used a monozygotic co-twin control study design. Pairs were selected from the Virginia Adult Twin Study of Psychiatric and Substance Use Disorders for discordance in age at onset of regular smoking. Nicotine dependence was measured by the Fagerstrom Test for Nicotine Dependence and level of craving.Results: The authors identified 175 male-male and 69 female-female monozygotic twin pairs who differed by at least 2 years in age at onset of regular smoking. During their period of heaviest smoking, the twin who began smoking earlier had significantly higher Fagerstrom Test scores in both the male-male (Cohen's d=0.20) and female-female twin pairs (d=0.26). Craving for cigarettes when unable to smoke was also higher in the early-onset member in both groups (male pairs, d=0.38; female pairs, d=0.25). The early-onset smoking twin did not differ froth the later-onset twin in symptoms of alcohol or cannabis abuse or dependence, current alcohol use, or maximal level of cannabis, sedative, stimulant, or cocaine use.Conclusions: Controlling for genetic and familial-environmental effects, age at onset of regular smoking predicted level of nicotine dependence. Consistent with the animal literature, these findings suggest that in humans, early nicotine exposure directly increases level of later nicotine dependence. These results should be interpreted in the context of the methodological strengths and limitations of the monozygotic co-twin design. (Am J Psychiatry 2013; 170:403-413)