Individual Differences in Smoking Exposure and Nicotine Dependence Sensitivity

描述(由申请人提供)：本申请是一项支持研究，将有关尼古丁暴露和敏感性的发展理论与最先进的统计方法相结合，旨在确定面临尼古丁依赖风险的独特人群亚群。到目前为止，风险研究的重点是抑郁症和酒精使用在吸烟行为和尼古丁依赖的出现中的作用，主要局限于评估吸烟暴露的可能性增加的努力。对这种联系的补充或替代解释是，抑郁和/或饮酒可能表明，在类似的使用水平下，对尼古丁依赖的敏感度增加。受目前赠款支持所获得的结果的启发，未来五年的目标是将传统和最新的统计方法应用于纵向数据的分析，其中包括对DSM-IV尼古丁依赖的评估和现有的最广泛的吸烟暴露措施。将讨论以下具体目标：1)描述与尼古丁依赖的出现有关的吸烟行为模式(如数量、频率、时间和持续时间)的个体差异。2)评估抑郁和酒精使用/障碍在促进吸烟增加和/或在类似使用水平下对尼古丁的敏感性增加方面的作用。3)确定预测人群亚群出现尼古丁依赖的显著和独特的风险/暴露途径。4)确定与每个显著风险/暴露途径相关的归因风险，以评估在人群中减少吸烟行为的潜力。将利用包括青少年和青年样本在内的现有数据。将使用多种统计技术来评估处于不同暴露水平的尼古丁依赖风险人群的存在，包括潜在类别分析(LCA)和分类和回归树(CART)分析。这些基于群体的方法将与传统的回归技术和接收者算子特征(ROC)分析相结合，以评估以变量为中心和基于群体的方法在尼古丁依赖病因中评估个体变异性的独特和互补作用。我们预计，拟议研究的完成将大大提高我们对吸烟病因的了解，从而为那些对尼古丁依赖发展最敏感的个人提供干预的目标、时间和内容。公共卫生相关性这项研究将更详细地了解青少年和年轻人对尼古丁依赖的性质和发病情况。确定对尼古丁依赖高度敏感的个人将为进一步降低吸烟率作出更有针对性的努力。

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.