Abstract：
OBJECTIVE: To examine the association between smoking initiation in adolescence and subsequent different smoking trajectories of people who smoke, and to examine the combined effect of adverse childhood experiences (ACEs) and smoking initiation in adolescence on smoking trajectories of people who smoke.
METHODS: Data are from 8757 individuals in Great Britain from the birth cohort National Child Development Study and who reported being smokers or former smokers by age 23.
METHODS: Smoking initiation in adolescence was measured at 16 y and smoking trajectories were derived from smoking variables from ages 23 to 55. We modelled the relationship between smoking initiation in adolescence with or without ACEs and smoking trajectories.
RESULTS: Individuals who initiated smoking in adolescence were more likely to quit later than quitting in twenties (RRR quitting in thirties = 3.43 [2.40; 4.89] p < .001; RRR quitting in forties = 5.25 [3.38; 8.14] p < .001; RRR quitting in fifties = 4.48 [2.95; 6.79] p < .001), to relapse (RRR Relapse = 3.66 [2.82; 4.76] p < .001) and to be persistent smokers (RRR persistent = 5.25 [3.81; 7.25] p < .001) compared to those who had initiated smoking in young adulthood. These effects were particularly pronounced in case of ACEs.
CONCLUSIONS: Smoking prevention programs aimed at reducing smoking initiation should be promoted to adolescents to limit the burden of smoking, especially for people who have suffered adversity during childhood.
METHODS: Data are from 8757 individuals in Great Britain from the birth cohort National Child Development Study and who reported being smokers or former smokers by age 23.
METHODS: Smoking initiation in adolescence was measured at 16 y and smoking trajectories were derived from smoking variables from ages 23 to 55. We modelled the relationship between smoking initiation in adolescence with or without ACEs and smoking trajectories.
RESULTS: Individuals who initiated smoking in adolescence were more likely to quit later than quitting in twenties (RRR quitting in thirties = 3.43 [2.40; 4.89] p < .001; RRR quitting in forties = 5.25 [3.38; 8.14] p < .001; RRR quitting in fifties = 4.48 [2.95; 6.79] p < .001), to relapse (RRR Relapse = 3.66 [2.82; 4.76] p < .001) and to be persistent smokers (RRR persistent = 5.25 [3.81; 7.25] p < .001) compared to those who had initiated smoking in young adulthood. These effects were particularly pronounced in case of ACEs.
CONCLUSIONS: Smoking prevention programs aimed at reducing smoking initiation should be promoted to adolescents to limit the burden of smoking, especially for people who have suffered adversity during childhood.
摘要：
目的：研究青春期开始吸烟与吸烟人群随后不同吸烟轨迹之间的关系，并检查不良童年经历（ACE）和青春期吸烟对吸烟人群吸烟轨迹的综合影响。
方法：数据来自英国出生队列国家儿童发展研究的8757名个体，他们报告在23岁时是吸烟者或曾经吸烟者。
方法：青春期开始吸烟的时间为16岁，吸烟轨迹来自23至55岁的吸烟变量。我们模拟了有或没有ACE的青春期开始吸烟与吸烟轨迹之间的关系。
结果：在青春期开始吸烟的人比二十多岁戒烟的人更有可能晚戒烟（三十多岁戒烟的RRR=3.43[2.40;4.89]p<.001；四十多岁戒烟的RRR=5.25[3.38;8.14]p<.001；五十多岁戒烟的RRR=4.48[2.95;6.79]p<.001），复发（RRR复发=3.66[2.82;4.76]p<.001）和持续吸烟者（RRR持续=5.25[3.81;7.25]p<.001）与年轻时开始吸烟的人相比。这些作用在ACE的情况下尤其明显。
结论：应向青少年推广旨在减少吸烟的预防吸烟计划，以减少吸烟负担，特别是对于那些在童年时遭受逆境的人。
方法：数据来自英国出生队列国家儿童发展研究的8757名个体，他们报告在23岁时是吸烟者或曾经吸烟者。
方法：青春期开始吸烟的时间为16岁，吸烟轨迹来自23至55岁的吸烟变量。我们模拟了有或没有ACE的青春期开始吸烟与吸烟轨迹之间的关系。
结果：在青春期开始吸烟的人比二十多岁戒烟的人更有可能晚戒烟（三十多岁戒烟的RRR=3.43[2.40;4.89]p<.001；四十多岁戒烟的RRR=5.25[3.38;8.14]p<.001；五十多岁戒烟的RRR=4.48[2.95;6.79]p<.001），复发（RRR复发=3.66[2.82;4.76]p<.001）和持续吸烟者（RRR持续=5.25[3.81;7.25]p<.001）与年轻时开始吸烟的人相比。这些作用在ACE的情况下尤其明显。
结论：应向青少年推广旨在减少吸烟的预防吸烟计划，以减少吸烟负担，特别是对于那些在童年时遭受逆境的人。
