尼古丁依賴程度與DSM-IV泛焦慮症症狀之相關探討：以某技術學院抽菸新生為例

A Correlation Study of Nicotine Dependence with Generalized Anxiety Disorder Symptoms in Freshmen

10.7023/TJFM.200506.0097

蔡崇煌(Chung-Huang Tsai)；陳宇嘉(Yu-Chia Chen)；黃素雲(Su-Yun Huang)；許維中(Wei-Chung Hsu)；劉永昌(Yung-Chang Liu)；林高德(Gau-De Lin)

adolescence ； cigarette smoking ； Fagerström test for nicotine dependence FTND ； DSM-IV ； generalized anxiety disorder GAD

台灣家庭醫學雜誌

15卷2期（2005 / 06 / 01）

97 - 107

繁體中文

過去之研究發現，在已開發國家中，大部份開始抽菸是在青少年時期，且一旦成癮後想戒菸須面對身心依賴的痛苦經驗，因此戒菸常導致失敗，所以想降低抽菸率應從青少年時期或成年早期即予以預防才是治本之道。本研究分析南投某技術學院九十一年度抽菸新生之尼古丁依賴程度與相關因素的探討，共收集有效樣本887人，其中129人(14.5%)有抽菸。尼古丁依賴程度以Fagerström test for nicotine dependence (FTND)為測試標準，結果發現一天抽菸量在20支以上者佔10.9%，早晨醒來以後5分鐘內抽第一支菸佔38.8%，早晨第一小時抽菸量最多者佔7.8%，最不願意放棄的是早晨第一支菸者佔29.5%，在禁菸場所會難以忍受者佔28.7%，即使生病臥床還是會抽菸者佔38.0%。較嚴重成癮者（FTND大於或等於7分以上）佔7.8%，大部份還是依賴程度較低者（FTND小於或等於3分）佔64.3%，約有50%抽菸者的FTND分數在2分左右。以逐步多元迴歸模型分析性別、年齡、畢業學校、未工作過或打工過、曾加入幫派否、常翹課否、關心課業情形及精神疾病診斷手冊第四版(DSM-IV)泛焦應症症狀與尼古丁依賴程度的關係，結果發現常翹課、泛焦慮症症狀較多及年齡較大者與尼古丁依賴程度有顯著正相關性。

The past studies have shown that most people in developed countries start cigarette smoking from adolescence. Once addicted, quitting smoking becomes very difficult and they could suffer both physical and mental problems. That is why quitting often ends in failure. To reduce cigarette smoking rates altogether, it should be prevented from adolescence. This study, using the Fagerström test for nicotine dependence (FTND), analyzed the correlation between nicotine dependence and associated factors with the Day Division students of a College of Technology who participated in entrance physical examinations in Nai-Tou County in 2002. A total of 887 subjects with 129 (14.5%) cigarette smokers were collected. The results showed that 10.9% of samples smoked more than 20 cigarettes a day. 38.8% of samples smoked in the first five minutes of when they got up in the morning. Nicotine dependents who usually smoked within the first hour of the morning constituted 7.8%. 29.5% of them never gave up the first cigarette in the morning. 28.7% found it difficult to stop smoking in no smoking areas. 38.0% continued smoking when they were sick. 7.8% were heavily addicted (FTND score≥7 points) and 64.3% were not heavily addicted (FTND score≤3 points). About 50% of samples got 2 points in the FTND score. The stepwise multiple regression model analyzed gender, age, school graduation, working experience, gang membership, leaving a lecture, which concerned their academic performance and DSM-IV generalized anxiety disorder (GAD) symptoms with FTND scores. The result showed that a higher chance of leaving a lecture, more DSM-IV generalized anxiety disorder (GAD) symptoms and older age had significant positive correlation with FTND scores.

1. 黃素雲、顏啟華、陳宇嘉、蔡崇煌、王雪鳳(2003)。某技術學院新生之抽菸行為及其相關因素之探討。台灣家醫誌，13，171-180。
   連結：
2. (1994).American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders.Washington, DC:American Psychiatric Association.
3. Azevedo A,Machado AP,Barros H(1999).Tobacco smoking among Portuguese high-school students World Health Organization.Bulletin of the World Health Organization, Geneva,77,509-514.
4. Brawman-Mintzer O,Lydiard RB(1996).Generalized anxiety disorder: Issue in epidemiology.J Clin Psychiatry,57,3-8.
5. Breslau N,Kilbey MM,Andreski P(1991).Nicotine dependence, major depression, and anxiety in young adults.Arch Gen Psychiatry,48,1069-1074.
6. Breslin FC,Adlaf EM(2002).Part-time work and cigarette use among teenagers.Can J Public Health,93,356-361.
7. Covey LS,Glassman AH,Stetner F,Rivelli S,Stage K(2002).A randomized trial of sertraline as a cessation aid for smokers with a history of major depression.Am J Psychiatry,159,1731-1737.
8. Dijkstra A,Tromp D(2002).Is the FTND a measure of physical as well as psychological tobacco dependence.J Subst Abuse Treat,23,367-374.
9. Glassman AH,Heizer JE,Covey LS(1990).Smoking, smoking cessation, and major depression.JAMA,264,1546-1549.
10. Goodman E,Capitman J(2000).Depressive symptoms and cigarette smoking among teens.Pediatrics,4,748-755.
11. Heatherton TF,Kozlowski LT,Frecker RC,Fagerstrom KO(1991).The Fagerström test for nicotine dependence: a revision of Fagerström tolerance questionnaire.Br J Addict,86,1119-1127.
12. Hu TW,Lin Z,Keeler TE(1998).Teenage smoking, attempts to quit, and school performance.Am J Public Health,88,940-943.
13. Johnson JG,Cohen P,Pine DS,Klein DF,Kasen S,Brook JS(2000).Association between cigarette smoking and anxiety disorders during adolescence and early adulthood.JAMA,8,2348-2351.
14. Kaufman NJ,Castrucci BC,Mowery PD,Gerlach KK,Emont S,Orleans T(2002).Predictors of change on the smoking uptake continuum among adolescents.Arch Pediatr Adolesc Med,156,581-587.
15. Kozlowski LT,Porter CQ,Orleans CT,Pope MA,Heatherton T(1994).Predicting smoking cessation with self-reported measures of nicotine dependence: FTQ, FTND and HSI.Drug Alcohol Depend,34,211-216.
16. Masi G,Favilla L,Mucci M(2000).Generalized anxiety disorder in adolescents and young adults with mild mental retardation.Psychiatry,63,54-64.
17. Michael FG(2000).Generalized anxiety disorder.Am Fam Physician,62,1591-1600.
18. O`Malley PM,Johnston LD,Anderson D,Bachman JG(1998).Alcohol use among adolescents.Alcohol Heath Res World,22,85-93.
19. Patton GC,Carlin JB,Coffey C,Wolfe R,Hibbert M,Bowes G(1998).Depression, anxiety, and smoking initiation: a prospective study over 3 years.Am J Public Health,88,1518-1522.
20. Pinilla J,Gonzalez B,Baber P,Santana Y(2002).Smoking in young adolescents: an approach with multilevel discrete choice models.J Epidemiol Community Health,56,227-232.
21. Rabatin J,Keltz LB(2002).Generalized anxiety and panic disorder.West J Med,176,164-174.
22. Reid P(2002).Guidelines for smoking cessation.Wellington, Zealand:National Health Committee.
23. Rynn MA,Siqueland L,Rickels K(2001).Placebo-controlled trial of sertraline in the treatment of children with generalized anxiety disorder.Am J Psychiatry,158,2008-2014.
24. Warren CW,Riley L,Asma S(2000).Tobacco use by youth: a surveillance report from the Global Youth Tobacco Survey project.Bull World Health Organ,78,868-876.
25. 許碧蓮(1992)。青少年吸煙行為研究。菁義季刊，1，45-50。
26. 黃德祥(1993)。青少年抽煙行為之調查研究－以一所私立高職為例。彰化師範大學學報，4，67-107。
27. 劉安彥、陳英豪(1999)。青年心理學，255-60,300-4。
28. 蔡文哲、李明濱編(2000)。實用精神醫學。台北:國立台灣大學醫學院。