Cigarette Smoking as a Risk Factor for Greater Psychiatric Symptom Severity across Serious Mental Illnesses: A Secondary Analysis of Three Nationally-Representative NIH Datasets

吸烟是严重精神疾病中更严重的精神症状的一个危险因素：对三个具有全国代表性的 NIH 数据集的二次分析

• 批准号: 10037725
• 负责人: David J Bond
• 金额: $ 23.11万
• 依托单位: UNIVERSITY OF MINNESOTA
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-08-01 至 2022-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10037725
• 关键词: Affect; Alcohol or Other Drugs use; American; Bipolar Disorder; Cigarette; Clinical Treatment; Communities; Data; Data Set; Distress; Education; Foundations; General Population; Health; Hospitalization; Impairment; Investigation; Label; Lesbian Gay Bisexual Transgender Queer; Life; Light; Major Depressive Disorder; Manic; Medical; Mental Depression; Mental Health; Mental disorders; Minority; Modeling; Moods; Multimedia; National Institute of Mental Health; Persons; Play; Population Study; Psychopathology; Public Health; Relapse; Risk Factors; Role; Schizophrenia; Severities; Severity of illness; Smoke; Smoker; Smoking; Smoking Behavior; Smoking Prevention; Symptoms; Syndrome; Time; Tobacco use; Treatment Factor; United States; United States National Institutes of Health; Work; Youth; cigarette smoke; cigarette smoking; comorbidity; cost; depressive symptoms; design; experience; insight; non-smoker; programs; psychiatric symptom; secondary analysis; severe mental illness; smoking cessation; sociodemographics; success; suicidal behavior; tobacco products; tobacco regulatory science

PROJECT ABSTRACT Over the past 50 years, the US smoking rate was reduced by two-thirds from 42% in the 1960s to 14% currently. Smoking prevention campaigns, such as those led by the Center for Tobacco Products, include multimedia educational programs and health warning labels on cigarette packaging, which are highly effective and played a key role in this reduction. However, smoking rates remain high in certain vulnerable subpopulations (e.g. youth, minorities, LGBTQ people) and the CTP is now targeting smoking prevention campaigns to these subpopulations. One vulnerable subpopulation that has not yet been targeted is people with serious mental illnesses (SMIs) such as bipolar disorder (BD), schizophrenia (SCZ), and major depressive disorder (MDD). SMIs affect more than 1 in 5 Americans and people with SMIs are twice as likely to smoke as people without SMIs. Accordingly 40% of all cigarettes are smoked by people with SMIs. Education campaigns have long been used to reach people with SMIs and have been successful in increasing treatment rates and reducing suicidal behavior. In light of their success, the lack of a smoking prevention campaign targeted to the SMI subpopulation is striking. The first step in designing a successful campaign is establishing the scientific foundation for messaging that will resonate with the SMI subpopulation. Focusing on the mental health consequences of smoking is a logical choice. People with SMIs typically spend 15%-25% of their lives symptomatic, and symptoms are distressing, cause role impairment, and when severe require hospitalization. We will conduct the most rigorous investigation yet done on whether smoking is a risk factor for greater psychiatric symptom severity in people with SMIs, using three specific aims: SA1: Determine whether smoking is a risk factor for increased time in illness episodes in people with SMIs. We hypothesize that BD smokers will spend more time in mood episodes (depression+mania) than BD non-smokers, SCZ smokers will spend more time in psychotic episodes, and MDD smokers will spend more time in depressive episodes. SA2: Determine whether smoking is a risk factor for increased time in depression across SMIs. Depression is the psychiatric syndrome most commonly attributed to smoking, and people with BD, SCZ, and MDD are all vulnerable to depression. An alternate hypothesis to SA1 is that smoking has a specific depressogenic effect and that across all three SMIs smokers will spend more time in depressive episodes than non-smokers. SA3: Determine predictors of within-person changes in smoking behavior (initiating, quitting, relapsing). We hypothesize that smokers with lower psychiatric symptom severity will be more likely to quit smoking, while quitters who experience a subsequent increase in symptoms will be more likely to relapse into smoking. The proposed project will advance tobacco regulatory science and protect public health by establishing the scientific foundation for a smoking prevention campaign targeted to people with SMIs - arguably the vulnerable subpopulation most harmed by smoking.

项目摘要 在过去的50年里，美国的吸烟率从20世纪60年代的42%下降到14%， 目前。吸烟预防运动，如烟草产品中心领导的运动，包括 多媒体教育节目和香烟包装上的健康警告标签，这是非常有效的 并在这一减少中发挥了关键作用。然而，吸烟率仍然很高，在某些脆弱的 亚人群（如青年，少数民族，LGBTQ人群）和CTP现在的目标是预防吸烟 对这些亚群体的运动。一个尚未成为目标的脆弱亚群是 患有严重精神疾病（SMI）的人，如双相情感障碍（BD），精神分裂症（SCZ）， 重度抑郁症（MDD）。SMI影响超过五分之一的美国人，患有SMI的人是正常人的两倍。 和没有SMIs的人一样容易吸烟。因此，40%的香烟是由吸烟的人吸的。 SMIs。长期以来，教育运动一直被用来接触患有重度精神疾病的人，并在以下方面取得了成功： 提高治疗率和减少自杀行为。鉴于他们的成功，没有吸烟 针对重度精神病患者亚群的预防运动引人注目。设计一个成功的 这项活动正在为与SMI产生共鸣的信息传递建立科学基础 亚群关注吸烟对心理健康的影响是一个合乎逻辑的选择。患有SMI的人 通常花费15%-25%的生命症状，症状是令人痛苦的，导致角色障碍， 严重时需要住院治疗。我们将进行最严格的调查， 吸烟是重度精神疾病患者精神症状严重程度增加的危险因素，使用三个具体目标： SA 1：确定吸烟是否是增加疾病发作时间的风险因素， SMIs。我们假设，BD吸烟者将花费更多的时间在情绪发作（抑郁+躁狂）比BD 非吸烟者，SCZ吸烟者将花费更多的时间在精神病发作上，MDD吸烟者将花费更多的时间在精神病发作上， 抑郁发作的时间。SA 2：确定吸烟是否是增加吸烟时间的风险因素 抑郁症在SMIs抑郁症是最常归因于吸烟的精神综合征， BD、SCZ和MDD患者都容易患抑郁症。SA 1的另一个假设是， 吸烟具有特定的致抑郁作用，在所有三种SMIs中，吸烟者将花费更多的时间 抑郁症发作次数比不吸烟者多。SA 3：确定吸烟者内部变化的预测因素 行为（开始、退出、复发）。我们假设精神症状较轻的吸烟者 严重程度将更有可能戒烟，而戒烟者谁的经验，随后增加的症状 更有可能重新吸烟。拟议的项目将推进烟草监管科学， 为预防吸烟运动建立科学基础，以保护公众健康， 患有重度精神疾病的人-可以说是受吸烟危害最大的弱势群体。