Nicotine Dependence in Early Adulthood

描述（由申请人提供）：这是对最初于2006年10月1日提交的提案的修订，要求三年的支持（5/1/08-4/30/11），以调查尼古丁依赖症状的发生、稳定和缓解，不同依赖模式的潜在风险和保护因素，以及从青春期晚期到成年早期的四年间隔内的依赖后果，这是获得烟草使用行为的关键发展时期。本研究有六个主要目标：(1)确定尼古丁依赖症状的开始、稳定和变化模式，以及从青春期中期到成年早期依赖症状的发展轨迹；(2)在发展社会化框架内确定促进（危险因素）依赖和减少（保护因素）依赖的社会、心理和生物因素；(3)识别预测依赖持续的社会、心理和生物因素；(4)确定尼古丁依赖的社会心理和健康后果；(5)明确尼古丁依赖与抑郁症等精神疾病的共病、排序及相互作用；(6)在探索性分析中，确定非西班牙裔白人、非西班牙裔非裔美国人和西班牙裔青年之间的性别、种族/民族差异，以及与目标(#1)-(#5)相关的烟草使用年龄。这些目标将通过对1036名青少年进行新一轮的电话数据收集来实现。我们上一次与这些青少年接触是在2005年，他们的平均年龄为16.6岁（st. dev=1.3）， 2009年再次对他们进行访问时，他们的平均年龄将为20.6岁。这些青少年在2003年2月至2005年10月的两年期间接受了五次访谈。这项研究是一项独特的尝试，旨在前瞻性地调查青少年和成年早期尼古丁依赖开始和持续的风险期，从开始到依赖的持续时间，解释发病的因素，依赖的慢性和缓解，尼古丁依赖的后果，以及吸烟，尼古丁依赖和精神疾病在不同种族的男性，女性和青少年中的共病。这一额外的数据收集浪潮的一个关键好处是更新尼古丁依赖和其他烟草使用行为的表型，以便在比迄今为止更长的风险期内进行遗传分析。这项研究将对年轻人尼古丁依赖的自然历史、病因和后果产生独特的理解。公共卫生相关性：慢性吸烟是导致人群发病率和死亡率的最主要因素之一。本研究旨在确定导致尼古丁依赖的过程，其潜在的风险和保护因素，以及其对青春期和成年早期身体健康和社会心理功能的影响。这些过程需要从青春期开始进行研究，因为开始使用烟草是在青春期，而早起与长期使用有关。该结果将对尼古丁依赖的早期诊断和预防、干预和治疗工作的发展具有重要的公共卫生意义。研究结果将表明，为了防止和减少尼古丁依赖的进展，何时、与谁以及如何进行干预。

DESCRIPTION (provided by applicant): This revision of a proposal submitted initially on 10/1/06 requests three years of support (5/1/08-4/30/11) to investigate the onset, stability and remission in symptoms of nicotine dependence, the underlying risk and protective factors for different patterns for dependence, and the consequences of dependence over a four-year interval from late adolescence to early adulthood, in a crucial period of development for the acquisition of tobacco use behavior. The research has six major goals: (1) To identify patterns of initiation, stability and change in symptoms of nicotine dependence, and developmental trajectories of dependence symptoms from mid adolescence to early adulthood; (2) To identify the social, psychological and biological factors, within the Developmental Socialization framework, that promote (risk factors) and those that reduce (protective factors) dependence; (3) To identify the social, psychological and biological factors that predict persistence of dependence; (4) To identify the psychosocial and health consequences of nicotine dependence; (5) To specify the comorbidity, sequencing and reciprocal effects between nicotine dependence and depression and other psychiatric disorders; (6) In exploratory analyses, to identify differences by gender, race/ethnicity between non-Hispanic white, non-Hispanic African American and Hispanic youths, and age of tobacco use onset with respect to Aims (#1)-(#5). These aims will be achieved by conducting a new wave of data collection by telephone on a cohort of 1,036 adolescents, whom we last contacted in 2005 at mean age of 16.6 years (st. dev=1.3) and who will be 20.6 years on average when reinterviewed in 2009. These youths were previously interviewed five times over a two-year interval, from 2/2003 to 10/2005. This study represents a unique attempt to investigate prospectively the periods of risk for initiation and persistence of nicotine dependence in adolescence and early adulthood, the duration from onset to dependence, the factors that explain onset, chronicity and remission of dependence, the consequences of nicotine dependence, and the comorbidity among smoking, nicotine dependence, and psychiatric disorders among males and females and youths of different ethnicities. A crucial benefit of this additional wave of data collection is the update of phenotypes of nicotine dependence and other tobacco use behaviors for genetic analyses over a longer risk period than available to date. The study will generate a unique understanding of the natural history, etiology and consequences of nicotine dependence among young people. PUBLIC HEALTH RELEVANCE: Chronic smoking is one of the strongest contributors to morbidity and mortality in the population. This study proposes to identify the processes leading to nicotine dependence, its underlying risk and protective factors, and its consequences for physical health and psychosocial functioning in adolescence and early adulthood. These processes need to be studied beginning in adolescence since onset of tobacco use occurs in adolescence and early onset is associated with chronic use. The results will have important public health implications for the early diagnosis of nicotine dependence and the development of prevention, intervention and treatment efforts. The findings will indicate when, with whom, and how to intervene in order to prevent and reduce progression to nicotine dependence.