Nicotine Dependence in Early Adulthood

描述（申请人提供）：对最初于2006年1月10日提交的提案的修订要求提供三年的支持（2008年5月1日至2011年4月30日）研究尼古丁依赖症状的发作、稳定性和缓解，不同依赖模式的潜在风险和保护因素，以及从青少年后期到成年早期的四年时间间隔内依赖的后果，这是获得烟草使用行为的关键发展时期。该研究有六个主要目标：（1）确定尼古丁依赖症状的启动，稳定和变化模式，以及从青春期中期到成年早期的依赖症状的发展轨迹;（2）在发展社会化框架内确定促进尼古丁依赖的社会，心理和生物因素。（风险因素）和那些减少（3）确定预测依赖持续性的社会、心理和生物因素;（4）确定尼古丁依赖的心理社会和健康后果;（5）明确尼古丁依赖与抑郁等精神障碍的共病性、顺位性和交互作用;（6）在探索性分析中，确定非西班牙裔白色、非西班牙裔非洲裔美国人和西班牙裔青年之间的性别、种族/民族差异，和烟草使用开始的年龄相对于目的（#1）-（#5）。这些目标将通过对1 036名青少年进行新一轮电话数据收集来实现，我们最后一次接触这些青少年是在2005年，平均年龄为16.6岁（标准差=1.3），2009年再次访问时，他们的平均年龄将为20.6岁。在2003年2月至2005年10月的两年时间里，对这些青年进行了五次访谈。这项研究代表了一种独特的尝试，旨在前瞻性地调查青春期和成年早期尼古丁依赖开始和持续的风险期，从发作到依赖的持续时间，解释依赖发作，慢性化和缓解的因素，尼古丁依赖的后果，以及吸烟，尼古丁依赖，在不同种族的男女和青年中，这一额外数据收集浪潮的一个关键好处是，在比迄今为止更长的风险期内更新尼古丁依赖和其他烟草使用行为的表型，以进行遗传分析。这项研究将对年轻人尼古丁依赖的自然史、病因和后果产生独特的理解。公共卫生相关性：慢性吸烟是人口发病率和死亡率的最大贡献者之一。这项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，以及其对青少年和成年早期身体健康和心理社会功能的影响。这些过程需要从青少年开始研究，因为烟草使用发生在青少年时期，早期发作与长期使用有关。研究结果将对尼古丁依赖的早期诊断以及预防、干预和治疗工作的发展产生重要的公共卫生影响。研究结果将表明何时，与谁以及如何进行干预，以预防和减少尼古丁依赖的进展。

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.