Individual Differences in Smoking Exposure and Nicotine Dependence Sensitivity

描述（由申请人提供）：本申请请求支持开展研究，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结合起来，旨在定义具有尼古丁依赖风险的独特人群亚群。迄今为止，关注抑郁和酒精使用在吸烟行为和尼古丁依赖出现中的作用的风险研究主要局限于旨在评估吸烟暴露可能性增加的努力。对这种关联的一种补充或替代解释是，抑郁和/或饮酒可能表明，在相似的使用水平下，对尼古丁依赖的敏感性增加。受目前资助的启发，未来五年的目标是应用传统和最先进的统计方法来分析纵向数据，包括评估DSM-IV尼古丁依赖和最广泛的吸烟暴露措施。以下具体目标将被解决：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)评估抑郁症和酒精使用/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)确定预测人群亚群尼古丁依赖出现的突出和独特的风险/暴露途径。4)确定与每个突出风险/暴露途径相关的归因风险，以评估人群中吸烟行为减少的潜力。将利用现有数据，包括青少年和青年样本。将使用多种统计技术来评估在不同暴露水平下存在尼古丁依赖风险的人群亚群的存在，包括潜在类分析（LCA）和分类与回归树（CART）分析。这些基于群体的方法将与传统的回归技术和接受者算子特征（ROC）分析相辅相成，以评估以变量为中心和基于群体的方法在评估尼古丁依赖病因学中的个体差异方面的独特和互补贡献。我们期望这些研究的完成将大大提高我们对吸烟病因的理解，从而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。这项研究将为青少年和年轻人尼古丁依赖的性质和发病提供更详细的了解。对尼古丁依赖高易感性个体的识别将为进一步降低吸烟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.