Effects of progression to cigarette smoking on depressed mood in adolescents:: evidence from the National Longitudinal Study of Adolescent Health
Effects of progression to cigarette smoking on depressed mood in adolescents:: evidence from the National Longitudinal Study of Adolescent Health
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DOI：
10.1111/j.1360-0443.2007.02052.x
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发表时间：
2008-01-01
期刊：
影响因子：
6
通讯作者：
Niaura, Raymond
中科院分区：
文献类型：
--
作者：
Munafo, Marcus R.;Hitsman, Brian;Niaura, Raymond
目的探讨青少年吸烟状况与抑郁情绪的关系。设计准实验设计，选择在基线时从未吸烟的青少年，其中一些人在随访约1年后进展为吸烟。设置数据来自全国青少年健康纵向研究，正在进行的研究，旨在评估青少年的健康状况，并探讨青少年健康相关行为的原因。来自美国的青少年的全国代表性样本（n = 12149），包括一个在基线时从未吸烟的子样本（n = 5475），基线时平均年龄为15岁，主要是欧洲血统。Logistic和线性回归模型控制潜在的混杂因素，以探讨吸烟状态和抑郁情绪之间的关系，使用流行病学研究中心抑郁量表（CES-D）测量。结果吸烟状况和抑郁情绪之间的各种关系进行了观察，这些影响的总体趋势是更大的女性。基线时的吸烟状态并不能显著预测随访时的CES-D评分，尽管这种效应在女性中接近显著性（P = 0.077）。在基线时从不吸烟者中，基线时的抑郁情绪水平可预测随后进展为开始吸烟（P = 0.022），但不能预测进展为定期吸烟（P = 0.229）。在基线从不吸烟者中，在随访期间开始吸烟的进展与随访时更高的CES-D评分相关，即使在调整基线抑郁情绪后也是如此（P < 0.001），女性的这种影响大于男性。在那些开始吸烟的人中，女性（P = 0.001），而不是男性（P = 0.966），在随访时进展到定期吸烟与更高的CES-D评分相关。结论这些数据似乎支持抑郁情绪和吸烟状况之间的关系，其中包括混杂和因果模型的元素的复杂模型。吸烟和抑郁症之间的关系可能是随后依赖性发展的一个因素。
Aims To investigate the relationship between smoking status and continuously distributed depressed mood among a cohort of adolescents. Design Quasi-experimental design, selecting the subset of adolescents who reported never having smoked a cigarette at baseline, some of whom progressed subsequently to smoking at follow-up approximately 1 year later. Setting Data were drawn from the National Longitudinal Study of Adolescent Health, an ongoing study designed to assess the health status of adolescents, and explore the causes of adolescent health-related behaviours. Participants Nationally representative sample of adolescents from the USA (n = 12 149), including a subsample who reported never having smoked a cigarette at baseline (n = 5475), aged on average 15 years at baseline and of predominantly European ancestry. Measurements Logistic and linear regression models controlling for potential confounders to explore the relationship between smoking status and depressed mood measured using the Centers for Epidemiological Studies Depression Scale (CES-D). Findings Various relationships between smoking status and depressed mood were observed, with a general trend for these effects to be greater among females. Smoking status at baseline did not significantly predict CES-D score at follow-up, although this effect approached significance in females (P = 0.077). Among never smokers at baseline, level of depressed mood at baseline predicted subsequent progression to smoking initiation (P = 0.022) but not progression to regular smoking (P = 0.229). Among never smokers at baseline, progression to smoking initiation during the follow-up period was associated with higher CES-D scores at follow-up, even after adjusting for baseline depressed mood (P < 0.001), with this effect greater for females than for males. Among those who initiated smoking, progression to regular smoking was associated with higher CES-D score at follow-up among females (P = 0.001), but not males (P = 0.966). Conclusions These data appear to support a complex model of the relationship between depressed mood and smoking status which includes elements of both confounding and causal models. The relationship between cigarette smoking and depression may be a factor in the development of subsequent dependence.