Elena Raffetti1, Anton Jonatan Landgren2, Filip Andersson3, Francesco Donato4, Catharina Lavebratt5, Yvonne Forsell3, Maria Rosaria Galanti3. 1. Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden. Electronic address: elena.raffetti@ki.se. 2. Department of Rheumatology and Inflammation Research, Sahlgrenska Academy, University of Gothenburg, Göteborg, Sweden. 3. Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden; Centre for Epidemiology and Community Medicine, Stockholm Region, Stockholm, Sweden. 4. Unit of Hygiene, Epidemiology and Public Health, University of Brescia, Brescia, Italy. 5. Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden; Center for Molecular Medicine, Karolinska University Hospital, Solna, Sweden.
Abstract
PURPOSE: Stress potentiates the smoking reward, decreases the ability to resist smoking, and increases the risk of smoking relapse in adulthood. This study aimed to clarify if salivary cortisol, as an indicator of stress, may be prospectively associated with the onset and phenotype of tobacco use in adolescents. METHODS: This study was based on a cohort of Swedish adolescents, among whom saliva specimens were collected from a nested sample. We included adolescents with salivary cortisol measurements and without a history of tobacco use (n = 381, aged 13-14 years). Quartiles of morning and afternoon cortisol concentration and cortisol area under the curve were considered as predictors. We categorized tobacco use according to the product mainly used: cigarette smoking, snus use, or either type of tobacco. For each product use, two outcomes were considered: initiation and duration of use. Poisson regression models were used to calculate rate ratios. RESULTS: A quartile increase in morning cortisol levels and cortisol area under the curve was consistently associated with a 1.2- to 1.4-fold increased risk of initiation of cigarette smoking snus use, or any tobacco use. Similar results were obtained examining the dose-response relationship and using the duration of use as outcome. No associations were apparent between afternoon cortisol concentration and any of the outcomes. All associations were similar between sexes. CONCLUSIONS: Morning cortisol concentration, an indicator of hypothalamic-pituitary-adrenal axis activation, is prospectively associated with tobacco use in adolescents. Whether this activation indicates the cumulative effect of stressors during the life course remains to be elucidated.
PURPOSE:Stress potentiates the smoking reward, decreases the ability to resist smoking, and increases the risk of smoking relapse in adulthood. This study aimed to clarify if salivary cortisol, as an indicator of stress, may be prospectively associated with the onset and phenotype of tobacco use in adolescents. METHODS: This study was based on a cohort of Swedish adolescents, among whom saliva specimens were collected from a nested sample. We included adolescents with salivary cortisol measurements and without a history of tobacco use (n = 381, aged 13-14 years). Quartiles of morning and afternoon cortisol concentration and cortisol area under the curve were considered as predictors. We categorized tobacco use according to the product mainly used: cigarette smoking, snus use, or either type of tobacco. For each product use, two outcomes were considered: initiation and duration of use. Poisson regression models were used to calculate rate ratios. RESULTS: A quartile increase in morning cortisol levels and cortisol area under the curve was consistently associated with a 1.2- to 1.4-fold increased risk of initiation of cigarette smoking snus use, or any tobacco use. Similar results were obtained examining the dose-response relationship and using the duration of use as outcome. No associations were apparent between afternoon cortisol concentration and any of the outcomes. All associations were similar between sexes. CONCLUSIONS: Morning cortisol concentration, an indicator of hypothalamic-pituitary-adrenal axis activation, is prospectively associated with tobacco use in adolescents. Whether this activation indicates the cumulative effect of stressors during the life course remains to be elucidated.
Authors: Dana Zeid; Lisa R Goldberg; Laurel R Seemiller; Sean Mooney-Leber; Philip B Smith; Thomas J Gould Journal: Neurotoxicol Teratol Date: 2021-03-13 Impact factor: 3.763
Authors: Elena Raffetti; Philippe Anastasios Melas; Anton Jonatan Landgren; Filip Andersson; Yvonne Forsell; Catharina Lavebratt; Maria Rosaria Galanti Journal: Transl Psychiatry Date: 2021-09-15 Impact factor: 6.222