Co-occurrence of tobacco product use, substance use, and mental health problems among adults: Findings from Wave 1 (2013-2014) of the Population Assessment of Tobacco and Health (PATH) Study
Co-occurrence of tobacco product use, substance use, and mental health problems among adults: Findings from Wave 1 (2013-2014) of the Population Assessment of Tobacco and Health (PATH) Study
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DOI：
10.1016/j.drugalcdep.2017.03.032
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发表时间：
2017-08-01
影响因子：
4.2
通讯作者：
Compton, Wilson M.
中科院分区：
文献类型：
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作者：
Conway, Kevin P.;Green, Victoria R.;Compton, Wilson M.
背景资料：尽管美国成年人中非卷烟烟草产品的使用正在增加，但其与物质使用和心理健康问题的关系尚不清楚。这项研究调查了来自第一波的32，202名美国成年人中烟草使用，物质使用和心理健康问题的共同发生，以及性别的适度（2013-2014年）的全国代表性纵向烟草与健康人口评估（PATH）研究。参与者自我报告目前的香烟，电子烟，传统雪茄，小雪茄，过滤雪茄，水烟，无烟烟草和其他烟草产品的使用;结果：与非当前烟草使用者相比，当前烟草使用者更有可能报告酒精或药物使用（调整后的比值比（AOR）= 2.6; 95%置信区间（CI）：2.3，2.9），与雪茄和水烟用户观察到的最强关联。在所有烟草产品组中，使用者比非使用者更有可能报告内化（AOR = 1.9; 95% CI：1.7，2.1），外化（AOR = 1.6; 95% CI：1.5，1.8）和物质使用（AOR = 3.4; 95% CI：2.9，4.1）问题。性别调节了许多这些关联，其中，所有非卷烟烟草产品的关联在女性中更强。这项对美国成年人的全国代表性研究是第一项全面记录烟草使用、物质使用和精神健康合并症的研究，涉及目前可用的烟草产品，同时也表明，女性烟草使用者使用药物和精神健康问题的风险增加。这些调查结果可能表明，在脆弱性方面存在性别差异，并表明干预措施应纳入针对性别的办法。
Background: Although non-cigarette tobacco product use is increasing among U.S. adults, their associations with substance use and mental health problems are unclear. This study examined co-occurrence of tobacco use, substance use, and mental health problems, and its moderation by gender, among 32,202 U.S. adults from Wave 1 (2013-2014) of the nationally representative longitudinal Population Assessment of Tobacco and Health (PATH) Study.Methods: Participants self-reported current cigarette, e-cigarette, traditional cigar, cigarillo, filtered cigar, hookah, smokeless tobacco and other tobacco product use; past year alcohol, marijuana, and other drug use; and past year substance use, internalizing and externalizing problems.Results: Compared to non-current tobacco users, current users were more likely to report alcohol or drug use (adjusted odds ratio (AOR) = 2.6; 95% confidence interval (CI): 2.3, 2.9), with the strongest associations observed for cigarillo and hookah users. Across all tobacco product groups, users were more likely to report internalizing (AOR = 1.9; 95% CI: 1.7, 2.1), externalizing (AOR = 1.6; 95% CI: 1.5, 1.8), and substance use (AOR = 3.4; 95% CI: 2.9, 4.1) problems than non-users. Gender moderated many of these associations and, of these, all non-cigarette tobacco product associations were stronger among females.Conclusions: This nationally representative study of U.S. adults is the first to comprehensively document tobacco use, substance use, and mental health comorbidities across the range of currently available tobacco products, while also demonstrating that female tobacco users are at increased risk for substance use and mental health problems. These findings may point to gender differences in vulnerability and suggest that interventions incorporate gender-specific approaches.