Individual Differences in Smoking Exposure and Nicotine Dependence Sensitivity

描述（由申请人提供）：本申请代表了一项支持研究的请求，该研究将尼古丁暴露和敏感性的发育理论与最先进的统计方法相结合，旨在定义存在尼古丁依赖风险的独特人群亚组。迄今为止，风险研究的重点是抑郁症和酒精使用的吸烟行为和尼古丁依赖的出现的作用，主要局限于旨在评估吸烟暴露的可能性增加的努力。对这种关联的一种补充或替代解释是，抑郁和/或酒精使用可能表明在相似的使用水平下对尼古丁依赖的敏感性增加。在通过当前赠款支持获得的研究结果的刺激下，未来五年的目标是将传统和最先进的统计方法应用于纵向数据分析，包括DSM-IV尼古丁依赖评估和最广泛的吸烟暴露措施。将解决以下具体目标：1）描述与尼古丁依赖出现相关的吸烟行为模式（例如，数量、频率、时间和持续时间）的个体差异。2)评价抑郁和酒精使用/障碍在促进吸烟暴露增加和/或在相似使用水平下对尼古丁敏感性增加方面的作用。3)确定预测人群亚组出现尼古丁依赖的突出和独特的风险/暴露途径。4)确定与每种主要风险/暴露途径相关的归因风险，以评估减少人群吸烟行为的潜力。将利用现有数据，包括青少年和年轻成人样本。将使用多种统计技术评价不同暴露水平下存在尼古丁依赖风险的人群亚组的存在情况，包括潜在类别分析（LCA）和分类回归树（CART）分析。这些基于组的方法将与传统的回归技术和受试者操作特征（ROC）分析相结合，以评价以变量为中心和基于组的方法在评价尼古丁依赖病因学个体变异性方面的独特贡献。我们预计，拟议研究的完成将大大促进我们对吸烟病因学的理解，这将为那些对尼古丁依赖发展最敏感的个体提供干预的目标、时间和内容。公共卫生相关性这项研究将提供对青少年和年轻人尼古丁依赖的性质和发作的更详细的了解。识别尼古丁依赖易感性高的个体将为进一步减少吸烟流行率提供更有针对性的努力。

DESCRIPTION (provided by applicant): This application represents a request for support to conduct research integrating developmental theory regarding nicotine exposure and sensitivity with state-of-the-art statistical methods aimed at defining unique population subgroups at risk for nicotine dependence. To date, risk research focused on the role of depression and alcohol use in the emergence of smoking behavior and nicotine dependence has largely been confined to efforts intended to evaluate increased probability of smoking exposure. A complimentary or alternate explanation for the association is that depression and/or alcohol use may signal increased sensitivity to nicotine dependence at similar levels of use. Stimulated by findings obtained through current grant support, the goal for the next five years is to apply both traditional and state-of-the-art statistical methods to the analysis of longitudinal data that includes assessment of DSM-IV nicotine dependence and the widest array of measures of smoking exposure available. The following specific aims will be addressed: 1) Describe individual differences in the patterning (e.g. quantity, frequency, timing and duration) of smoking behavior associated with the emergence of nicotine dependence. 2) Evaluate the role of depression and alcohol use/disorders in promoting increased exposure to smoking and /or increased sensitivity to nicotine at similar levels of use. 3) Identify prominent and unique risk/exposure pathways that predict the emergence of nicotine dependence for population subgroups. 4) Determine the attributable risk associated with each of the prominent risk/exposure pathways in order to evaluate the potential for reduction of smoking behavior in the population. Existing data will be utilized including adolescent and young adult samples. Multiple statistical techniques for evaluating the presence of population subgroups at risk for nicotine dependence at varying levels of exposure will be used including latent class analysis (LCA) and classification and regression tree (CART) analysis. These group-based approaches will be complimented with traditional regression techniques and Receiver Operator Characteristic (ROC) analysis in order to evaluate the unique and complimentary contributions of variable-centered and group-based methods for evaluating individual variability in the etiology of nicotine dependence. We expect that the completion of the proposed studies will substantially advance our understanding of smoking etiology that will inform the targets, timing and content of intervention for those individuals most sensitive to the development of nicotine dependence. PUBLIC HEALTH RELEVANCE This research will provide a more detailed understanding of the nature and onset of nicotine dependence in adolescents and young adults. The identification of individuals with high susceptibility to nicotine dependence will inform more targeted efforts for further reducing smoking prevalence.