禁煙が他の依存症回復に関連(Quitting smoking is associated with recovery from other addictions)

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2025-08-13 アメリカ国立衛生研究所(NIH)

米国のNIHの研究によると、アルコールや他の薬物への依存症を抱える人が喫煙もやめた場合、喫煙を続けた人と比べて依存状態からの回復を継続できる確率が42%高いことが明らかになりました。これは、PATH(Population Assessment of Tobacco and Health)研究に基づく全国規模のデータを分析した結果で、依存症治療の過程で禁煙を同時に進めることで、回復率の向上が期待できるという重要な示唆です。研究チームは、治療プログラムにおいて喫煙の断ち切りを積極的に組み込み、アルコールや薬物依存症からの回復を強力に支えるべきだと述べています。

<関連情報>

物質使用障害からの回復中の喫煙 Cigarette Smoking During Recovery From Substance Use Disorders

Michael J. Parks, PhD; Carlos Blanco, MD, PhD; MeLisa R. Creamer, PhD;et al
JAMA Psychiatry  Published;August 13, 2025
DOI:10.1001/jamapsychiatry.2025.1976

Key Points

Question Do changes in cigarette smoking predict substance use disorder (SUD) recovery over time, accounting for between-person confounders?

Findings In this longitudinal survey cohort study of 2652 participants, within-person transitions away from smoking were positively associated with SUD recovery in a nationally representative cohort; quitting smoking increased the odds of SUD recovery by 30% in fully adjusted models. Findings were robust in sensitivity analyses.

Meaning These results imply that quitting smoking is linked to better SUD recovery outcomes; smoking cessation could be a tool for assisting the recovery process among the millions of US adults with a current SUD.

Abstract

Importance Cigarette smoking is more prevalent among those with than without other substance use disorders (SUDs). However, smoking cessation interventions are often absent from SUD treatment facilities.

Objectives To inform smoking cessation and SUD care by assessing smoking status and SUD recovery over time to determine whether transitioning from current to former smoking is associated with sustained SUD recovery.

Design, Setting, and Participants This cohort study was conducted among a nationally representative cohort of US adults with history of SUD from the PATH (Population Assessment of Tobacco and Health) Study. The PATH Study is an ongoing, nationally representative, longitudinal cohort study in the US. Analyses included adults (aged ≥18 years) in the wave 1 cohort (recruited in 2013/2014) assessed annually over 4 years until wave 4 (2016/2018). A second nationally representative cohort (from 2016/2018 to 2023) was also assessed in sensitivity analyses. Data analysis was completed from June 2024 to September 2024.

Exposure Cigarette smoking (never, former, and current use).

Main Outcomes and Measures The primary outcome was SUD recovery, assessed via the Global Appraisal of Individual Needs–Short Screener SUD subscale, measured as high lifetime SUD symptoms (4-7 symptoms) and zero past-year symptoms (sustained remission) or high lifetime SUD symptoms with any past-year symptoms (current substance use or SUD). Fixed-effects logistic regression assessed within-person change in smoking and its association with SUD recovery, accounting for between-person confounders.

Results Among 2652 adults from 2013/2014 to 2016/2018, 41.9% of participants (95% CI, 39.4%-44.4%) were female, and mean age was 39.4 years (95% CI, 38.7-40.3). By self-reported race and ethnicity, 17.0% of participants (95% CI, 15.3%-18.9%) were Hispanic, 13.9% (95% CI, 12.2%-15.6%) were non-Hispanic Black, 63.1% (95% CI, 60.4%-65.7%) were non-Hispanic White, and 6.0% (95% CI, 4.9%-7.4%) were another non-Hispanic race (Asian, Native American/Alaska Native, Native Hawaiian/Other Pacific Islander, more than 1 race). Within-person change from current to former smoking was positively associated with SUD recovery: year-to-year change to former cigarette use was associated with a 30% increase in odds of recovery (odds ratio [OR], 1.30; 95% CI, 1.07-1.57), accounting for time-varying covariates and between-person differences. This association remained significant after lagging predictor by 1 year (OR, 1.43; 95% CI, 1.00-2.05) and in the second cohort assessed from 2016/2018 to 2022/2023 (OR, 1.37; 95% CI, 1.13-1.66).

Conclusions and Relevance In this cohort study, within-person change from current to former smoking was associated with recovery from other SUDs. These results suggest that smoking cessation could be used as a tool to assist recovery processes and improve health among adults with an SUD.

医療・健康
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