Role of depression and anxiety in the tobacco epidemic

描述(由申请人提供)： 香烟使用和尼古丁依赖目前被认为是全球最紧迫的公共卫生问题之一。吸烟是美国可预防死亡的主要原因，也是全世界发病率和过早死亡的最重要的可避免原因。与其他精神疾病(例如精神分裂症)不同，尼古丁依赖的发病和慢性可以在很大程度上得到预防或减轻。人们公认，遗传和环境因素在尼古丁依赖中发挥了作用，但迄今为止确定的因素似乎不能完全解释这种流行病的范围或难治性。最近的证据有力地表明了共病精神病理学在尼古丁依赖的发生和持续中的重要性。因此，该项目的总体目标是研究焦虑症与抑郁和尼古丁依赖之间的关系，检查这种联系的潜在机制，并确定这种联系在多大程度上可以推广到成年人口中研究不足的各个部分。 这项调查有两个主要的具体目标： 目的1：研究焦虑症和抑郁对社区成年人尼古丁依赖的发病、病程、持久性、发病率和抵消性的影响。 目的2：确定社区成年人中焦虑障碍与抑郁和尼古丁依赖之间联系的可能机制(例如，父母的精神病理学是否增加了抑郁和尼古丁依赖的易感性)。 虽然吸烟的流行率在过去几十年里有所下降，但这一下降并不是在所有人口群体中都是一样的，对尼古丁的依赖也没有普遍下降。尽管有与吸烟相关的健康风险方面的现有信息，但成年人继续开始吸烟并继续吸烟，特别是弱势群体，包括女性和年轻人。从拟议的调查中获得的信息将使我们能够利用现有的精神治疗工具开发更好的干预计划，旨在通过焦虑障碍和抑郁的一级和二级预防来减少香烟使用和尼古丁依赖的开始和持续。NESARC的使用提供了一个分析大型纵向流行病学数据集的独特机会。

DESCRIPTION (provided by applicant): Cigarette use and nicotine dependence are currently considered among the most pressing public health problems worldwide. Smoking is the leading cause of preventable death in the United States and the single most important avoidable cause of morbidity and premature mortality worldwide. Unlike other mental disorders (e.g., schizophrenia), the onset and chronicity of nicotine dependence could be largely prevented or diminished. It is accepted that genetic and environmental factors play a role in nicotine dependence, yet factors identified to date do not seem to completely explain this epidemic in scope or intractability. Recent evidence strongly suggests the importance of comorbid psychopathology in the onset and persistence of nicotine dependence. The overarching goal of this project is therefore to examine the relationship between anxiety disorders and depression and nicotine dependence, to examine potential mechanisms of this association, and to determine the extent to which it is generalizable to various understudied segments of the adult population. This investigation has two main Specific Aims: Aim 1: To examine the influence of anxiety disorders and depression on the onset, course, persistence, morbidity, and offset of nicotine dependence among adults in the community. Aim 2: To determine possible mechanisms of the association between anxiety disorders and depression and nicotine dependence among adults in the community (e.g., does parental psychopathology increase vulnerability to both depression and nicotine dependence). While the prevalence of cigarette smoking has declined over the past several decades, this decline has not been equal across all segments of the population and nicotine dependence has not declined as universally. Despite available information on the health risks associated with cigarette use, adults continue to initiate smoking and continue smoking, especially vulnerable segments of the population, including as females and young adults. Information gained from the proposed investigation would allow us to develop better intervention programs using existing psychiatric treatment tools aimed to reduce onset and persistence of cigarette use and nicotine dependence through both primary and secondary prevention of anxiety disorders and depression. Use of the NESARC offers a unique opportunity to analyze a large, longitudinal, epidemiologic dataset.