Depressive Symptoms and Tobacco Use Trajectories and Transitions across Young Adulthood

在美国，年轻人过去一年抑郁症和当前烟草使用的患病率最高。抑郁症和烟草使用的共同发生在年轻的成年期尤其成问题，因为尼古丁成瘾在这个发育期被固化，抑郁症状水平的升高促进了持续的烟草使用并破坏了戒烟。然而，对年轻人的研究有限，抑郁症状和烟草使用之间联系的强度和方向的证据也不确定。不确定的研究结果表明，在年轻人的亚组中，抑郁症状与烟草使用之间的关联模式可能存在异质性。然而，很少有研究探讨这种异质性。此外，大多数研究都集中在香烟上，尽管其他产品，如电子尼古丁输送系统，越来越普遍，同时使用两种或更多种产品（即，在年轻人中，使用混合烟草比使用单一产品更为普遍。使用新推出的电子烟包（例如JUUL）越来越令人担忧。但是，vape pod使用在抑郁症烟草使用协会中的作用尚不清楚。迫切需要进行纵向研究，以确定哪些人和在何种条件下抑郁症状与使用所有类型的烟草有关，以及与使用过渡有关，例如从目前使用烟草到不使用烟草，反之亦然。本R 01的主要目的是确定：1）抑郁症状在烟草使用轨迹和过渡中的作用是否因青少年（18-34岁）的亚组而异; 2）关联的强度和方向是否不同。我们将确定捕获异质性的调节因素，并定义谁和在什么条件下抑郁症状与烟草使用结果纵向相关。我们将研究社会人口统计学，自我和背景调节因素，以及所有类型的烟草产品和结果，包括开始，持续使用，成瘾，戒烟，聚烟草使用和使用过渡。为此，我们将使用2014-2019年从5，482名最初18-29岁的大学生中收集的八波现有数据。具体目标是：1）确定抑郁症状在纵向烟草使用轨迹和过渡中的作用，并阐明抑郁症状与烟草使用之间的时间关联; 2）检查社会人口学、个人因素和背景因素在纵向轨迹、过渡和时间关联中的调节作用;和3）确定vape豆荚，如JUUL，在纵向烟草使用轨迹，过渡和时间关联中的作用。预期的结果是确定亚组最容易开始和继续使用烟草，抑郁症状升高。研究结果可用于定制烟草干预措施，并确定其针对对象。

PROJECT SUMMARY Young adults have the highest prevalence of past-year depression and current tobacco use in the United States. Co-occurrence of depression and tobacco use is particularly problematic during young adulthood as nicotine addiction is solidified in this developmental period, and elevated levels of depressive symptoms promote sustained tobacco use and undermine quitting. Yet, there is limited research on young adults and evidence for the strength and direction of associations between depressive symptoms and tobacco use is inconclusive. Inconclusive findings indicate there may be heterogeneity in the patterns of associations between depressive symptoms and tobacco use across subgroups of young adults. Yet, few studies examine this heterogeneity. Further, most studies focus on cigarettes, although other products, such as electronic nicotine delivery systems, are increasingly prevalent and the concurrent use of two or more products (i.e., poly tobacco use) is more prevalent than single product use among young adults. Use of newly introduced vape pods, such as JUUL, is increasingly concerning. But, the role of vape pod use in the depressive symptoms-tobacco use association is not known. There is a critical need for longitudinal studies that identify for whom and under what conditions depressive symptoms are associated with use of all types of tobacco, and with transitions in use, such as from current to no tobacco use and vice versa. The primary objectives of this R01 are to determine if: 1) the role of depressive symptoms in tobacco use trajectories and transitions vary for subgroups across young adulthood, ages 18-34 and 2) the strength and direction of associations vary. We will identify moderating factors that capture the heterogeneity, and define for whom and under what conditions depressive symptoms are longitudinally associated with tobacco use outcomes. We will examine sociodemographic, intrapersonal, and contextual moderating factors, and all types of tobacco products and outcomes, including initiation, sustained use, addiction, cessation, poly tobacco use, and transitions in use. To do so, we will use eight waves of existing data collected in 2014-2019 from 5,482 initially 18-29 year old college students. The Specific Aims are to: 1) Identify the role of depressive symptoms in longitudinal tobacco use trajectories and transitions, and elucidate the temporal associations between depressive symptoms and tobacco use; 2) Examine the moderating roles of sociodemographic, intrapersonal, and contextual factors in the longitudinal trajectories, transitions, and temporal associations; and 3) Determine the role of vape pods, like JUUL, in the longitudinal tobacco use trajectories, transitions, and temporal associations. The expected outcome is identification of subgroups most vulnerable to initiating and continuing tobacco use, given elevated depressive symptoms. Results can be used to tailor tobacco interventions and determine to whom they should be targeted.