Are posttraumatic stress and depressive symptoms pathways to smoking relapse after a natural disaster?
Are posttraumatic stress and depressive symptoms pathways to smoking relapse after a natural disaster?
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DOI：
10.1016/j.drugalcdep.2018.09.025
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发表时间：
2019-02-01
影响因子：
4.2
通讯作者：
Stockton, Michelle
中科院分区：
文献类型：
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作者：
Alexander, Adam C.;Ward, Kenneth D.;Stockton, Michelle
背景：在灾难研究中很少研究吸烟复发。因此，本研究调查吸烟复发9个月和18个月后，卡特里娜飓风，并确定此outcome.Methods的途径和条件：数据来自一项前瞻性研究的成年吸烟者谁住在新奥尔良的时候卡特里娜飓风袭击（n = 1003），和比较样本的孟菲斯居民（n = 1001）谁没有直接受到飓风的影响。来自这两个城市的参与者是通过随机数字拨号招募的，并在卡特里娜飓风过后9个月和18个月接受了调查。我们评估了吸烟复发率是否不同的城市和评估潜在的调解人和主持人的这种关联使用条件过程analysis.Results：虽然吸烟复发，创伤后应激反应和抑郁症状的概率较高，新奥尔良比孟菲斯参与者，飓风暴露并没有间接影响吸烟复发，通过增加创伤后应激反应和抑郁症状。相反，随着飓风相关事件数量的增加，吸烟复发的可能性也随着抑郁（beta = 0.08，SE = 0.03，p = 0.02）和创伤后应激症状（beta = 0.08，SE = 0.04，p = 0.04）的增加而增加。社会支持降低吸烟复发的概率，防止增加抑郁和创伤后应激症状。结论：创伤后应激和抑郁症状介导的影响，灾难暴露吸烟复发，这种影响是最明显的幸存者谁报告灾难相关的压力。严重暴露于灾难的前吸烟者可能会从减少抑郁和创伤后应激症状的灾后干预中受益，这可能会防止吸烟复发。
Background: Smoking relapse is rarely examined in disaster research. Thus, this study investigated smoking relapse nine and eighteen months after Hurricane Katrina and identified pathways and conditions for this outcome.Methods: The data came from a prospective study of adult ever smokers who were living in New Orleans at the time Hurricane Katrina struck (n = 1003), and a comparison sample of Memphis residents (n = 1001) who were not directly impacted by the hurricane. Participants from both cities were recruited using random digit dialing and were surveyed nine and eighteen months after Hurricane Katrina. We assessed whether smoking relapse rates differed by city and evaluated potential mediators and moderators of this association using conditional process analysis.Results: Though the probabilities of smoking relapse, posttraumatic stress, and depressive symptoms were higher among New Orleans than Memphis participants, hurricane exposure did not indirectly affect smoking relapse through increases in posttraumatic stress and depressive symptoms. Instead, as the number of hurricane-related events increased so to did the probability of smoking relapse through increases in depressive (beta = 0.08, SE = 0.03, p = .02) and posttraumatic stress symptoms (beta = 0.08, SE = 0.04, p = .04). Social support lowered the probability of smoking relapse by protecting against increases in depressive and posttraumatic stress symptoms.Conclusions: Posttraumatic stress and depressive symptoms mediated the effects of disaster exposure on smoking relapse, and this effect was most pronounced among survivors who reported disaster-related stressors. Former smokers heavily exposed to disasters may benefit from postdisaster interventions that reduce depressive and posttraumatic stress symptoms, which may prevent smoking relapse.