Prevalence and correlates of a lifetime cannabis use disorder among pregnant former tobacco smokers
Prevalence and correlates of a lifetime cannabis use disorder among pregnant former tobacco smokers
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DOI：
10.1016/j.addbeh.2015.12.008
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发表时间：
2016-03-01
影响因子：
4.4
通讯作者：
Levine, Michele D.
中科院分区：
文献类型：
--
作者：
Emery, Rebecca L.;Gregory, Melissa P.;Levine, Michele D.
背景：大麻是继烟草和酒精之后怀孕期间最常用的物质。考虑到大麻和烟草同时使用的高流行率以及与产前物质使用相关的健康后果，我们试图记录通常与大麻使用相关的心理社会和精神因素在预测因怀孕而戒烟的女性终身大麻使用障碍（CUD）中的相对贡献。方法：在一项更大规模的产后烟草复吸预防随机对照试验中，纳入了妊娠前吸烟者（n = 273），完成了半结构化的精神病学访谈，并在妊娠晚期自我报告了人口统计学、妊娠、健康、心理社会和烟草使用因素。总共有14%（n = 38）的女性符合终身CUD的标准。终生CUD的最强预测因素是有多种精神疾病史（OR = 36.44; 95%CI = 5.03-264.27; p < 0.001），其次是终生酒精使用障碍（OR = 3.54; 95%CI = 1.27-9.87; p < 0.05）。此外，更频繁地尝试戒烟烟草（OR = 1.12，95%CI = 1.01-1.25，p < 0.05），戒烟后体重管理的自我效能感较低（OR = 0.78; 95%CI = 0.62-0.97; p < 0.05）也与终生CUD显著相关。有大麻和烟草依赖史的妇女可能是围产期需要更专业治疗以改善药物使用结果的妇女的一个子集。(C)2015爱思唯尔有限公司版权所有。
Background: Following tobacco and alcohol, cannabis is the most commonly used substance during pregnancy. Given the high prevalence of concurrent cannabis and tobacco use as well as the health consequences associated with prenatal substance use, we sought to document the relative contributions of psychosocial and psychiatric factors commonly associated with cannabis use in predicting a lifetime cannabis use disorder (CUD) among women who had quit smoking tobacco as a result of pregnancy.Methods: Pregnant former tobacco smokers (n = 273) enrolled in a larger randomized controlled trial for postpartum tobacco relapse prevention completed semi-structured psychiatric interviews and self-reported demographic, pregnancy, health, psychosocial, and tobacco use factors during their third trimester of pregnancy.Results: In total, 14% (n = 38) of women met criteria for a lifetime CUD. The strongest predictors of a lifetime CUD were a history of having multiple psychiatric disorders (OR = 36.44; 95% CI = 5.03-264.27; p < 0.001) followed by a lifetime alcohol use disorder (OR = 3.54; 95% CI = 1.27-9.87; p < 0.05). In addition, more frequent attempts to quit smoking tobacco (OR = 1.12; 95% CI = 1.01-1.25; p < 0.05) and lower self-efficacy about weight management after quitting smoking tobacco (OR = 0.78; 95% CI = 0.62-0.97; p < 0.05) also were significantly associated with a lifetime CUD.Conclusions: Women with a history of both cannabis and tobacco dependence may represent a subset of women who need more specialized treatment during the perinatal period to improve substance use outcomes. (C) 2015 Elsevier Ltd. All rights reserved.