SMOKING, SUICIDE AND MENTAL HEALTH: USING POLICY CHANGE TO PROBE CAUSALITY

吸烟、自杀和心理健康：利用政策变化来探究因果关系

• 批准号: 9169410
• 负责人: Richard A Grucza
• 金额: $ 22.89万
• 依托单位: WASHINGTON UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2016
• 资助国家: 美国
• 起止时间: 2016-09-30 至 2019-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9169410
• 关键词: Accounting; Affect; Air; Alcohol or Other Drugs use; Alcohols; Area; Attention; Awareness; Baseline Surveys; Behavioral Risk Factor Surveillance System; Cigarette; Cost-Benefit Analysis; Data; Death Records; Disease; Drug Use Disorder; Drug usage; Economics; Epidemiology; Etiology; Exhibits; Feeling suicidal; Frequencies; Health; High Prevalence; Individual; Intervention; Lead; Link; Literature; Major Depressive Disorder; Measurement; Measures; Mental Depression; Mental Health; Mental disorders; Modeling; National Health Interview Survey; Natural experiment; Nicotine; Outcome; Participant; Pathway interactions; Patients; Phenotype; Policies; Population; Public Health; Public Policy; Reporting; Research; Research Personnel; Risk; Role; Sampling; Science; Self Medication; Series; Smoke; Smoker; Smoking; Smoking Behavior; Suicide; Suicide attempt; Surveys; Taxes; Techniques; Testing; Tobacco; Tobacco use; Work; accomplished suicide; alcohol misuse; alcohol use disorder; analytical method; binge drinking; cost; design; follow-up; health related quality of life; meetings; mortality; non-smoker; population survey; prospective; public health research; public policy on tobacco; reducing suicide; screening; severe mental illness; smoking cessation; smoking prevalence; social; substance misuse; suicidal behavior; suicidal risk; tobacco control; tool

The association between smoking and suicide has been repeatedly documented, yet the proposition that smoking contributes directly to suicide risk is controversial and definitive evidence remains elusive. However, a growing body of research suggests that smoking may directly increase risk for psychiatric disorders, which would likely increase suicide risk. The global aim of this proposal is to examine whether smoking is a contributing cause for suicide and more proximal adverse mental health outcomes. We will leverage state tobacco control policy changes as natural experiments that lead to reduced prevalence of smoking. We propose that, as a result of their influence on smoking, these policy interventions also influence risk for suicide and mental health problems, including substance misuse. We will examine whether strengthening of tobacco control policies results in reduced risk for suicide and for adverse mental health outcomes. Furthermore, we will examine whether these associations are specific to smokers, as predicted by our model. We discuss our proof-of-concept study, which shows that strengthening of state tobacco control policies corresponds to reductions in suicide risk. We propose a three-year study that seeks to extend this finding using data on over one million survey participants with smoking measurements and prospective mortality follow-up. This will enable a much a much stronger analytical design than our initial study. We will also examine the associations of tobacco policy changes with psychiatric disorders and other adverse mental health outcomes, including suicidal behavior. This will enable us to identify specific channels through which smoking might influence mental health. We will take advantage of large, nationally representative epidemiological data to conduct these analyses and apply sophisticated analytic techniques that reduce the role of observed and unobserved confounders. These studies would have substantial impact on science by being a part of an emerging body of work that is challenging the traditional interpretation of the smoking-mental health link being due to “self-medication.” This work will also have impact on public health and policy by providing key parameters to cost/benefit analyses of tobacco control policies. Confirmation of our hypotheses could result in increased awareness of the importance of smoking cessation for mental health patients, and also prompt basic researchers to more closely scrutinize the influence of nicotine on phenotypes relevant to mental health. This latter contribution could be critical as emerging tobacco products grow in popularity.

吸烟与自杀之间的关联已被多次记录，但这一主张 吸烟是否直接导致自杀风险存在争议，并且尚缺乏明确的证据。 越来越多的研究表明吸烟可能直接增加精神疾病的风险， 可能会增加自杀风险。 该提案的全球目标是检查吸烟是否是导致自杀等的一个原因 我们将自然地利用国家烟草控制政策的变化。 我们认为，由于它们对吸烟的影响，导致吸烟率降低的实验。 吸烟，这些政策干预措施也会影响自杀和心理健康问题的风险，包括 我们将研究加强烟草控制政策是否会降低风险。 此外，我们将检查这些关联是否存在。 正如我们的模型预测的那样，是吸烟者特有的。 我们讨论了我们的概念验证研究，该研究表明加强国家烟草控制政策 我们提出了一项为期三年的研究，旨在利用这一结果来扩展这一发现。 超过一百万调查参与者的数据，包括吸​​烟测量和预期死亡率随访。 这将实现比我们最初的研究更强大的分析设计。 烟草政策变化与精神疾病和其他不良心理健康结果的关联， 包括自杀行为，这将使我们能够确定吸烟可能通过的具体渠道。 我们将利用大量具有全国代表性的流行病学数据来影响心理健康。 进行这些分析并应用复杂的分析技术来减少观察到的和 未观察到的混杂因素。 这些研究将成为新兴工作的一部分，对科学产生重大影响。 挑战对吸烟与心理健康联系的传统解释是“自我药疗”。 通过为成本/效益分析提供关键参数，工作还将对公共卫生和政策产生影响。 我们的假设的证实可能会提高人们对烟草控制政策重要性的认识。 心理健康患者戒烟的重要性，也促使基础研究人员更仔细地审视 尼古丁对与心理健康相关的表型的影响可能至关重要。 新兴烟草产品越来越受欢迎。