Socio-demographic and clinical-psychological predictors of smoking and alcohol abuse in health workers

Psychoemotional disorders caused by professional stress make a significant contribution to substance abuse by health workers, which requires studying specific predictors of the formation of addictive behavior and developing targeted prevention programs.
Aim. To study the socio-demographic and clinical-psychological predictors of smoking and alcohol abuse among health workers using the factor analysis method and taking into account gender differences.
Materials and methods. The sample consisted of 575 health workers (86.3% women), the average age was 42.7 ± 10.2 year. The structure of the factor analysis included socio-demographic data, parameters of clinical and psychological risk factors for addictive behavior (ASSIST test), indicators of the psychoemotional state (K10 and IES-R scales).
Results. Factor models were developed taking into account gender and the level of risk of substance use. Two risk groups for the use of nicotine-containing products (absence and low risk; moderate risk) and two risk groups for alcohol use (absence and low risk; moderate and high risk) were identified. The greatest contribution to the increase in the risk of abuse of nicotinecontaining products and alcohol for all groups was made by the factor of post-traumatic stress disorder and psychological distress, except for the group of male health workers who consumed alcohol with moderate or high risk. In the groups of health workers who consumed alcohol with moderate or high risk, regardless of gender, signs of anosognosia in relation to harmful alcohol consumption were observed.
Conclusion. The obtained results emphasize the importance of complex psychological and psychotherapeutic work with health workers who have specific socio-demographic, clinicalpsychological and psychoemotional predictors of substance abuse.

1. Wilson J., Tanuseputro P., Myran D.T., et al. Characterization of Problematic Alcohol Use Among Physicians: A Systematic Review. JAMA Netw Open. 2022; 5(12): e2244679. https://doi.org/10.1001/jamanetworkopen.2022.4479. PMID: 36484992; PMCID: PMC9856419

2. Joos L., Glazemakers I., Dom G. Alcohol use and hazardous drinking among medical specialists. European addiction research. 2013; 19(2): 89–97. https://doi. org/10.1159/000341993

3. Stadnik N., Nikitina S., Sakharova G., et al. Prevalence of tobacco consumption in the Russian Federation: analysis of trends in 2019-2022. Demographic Review. 2024; 11(1): 37–60 (In Russian). https://doi.org/10.17323/demreview.v11i1.20931. EDN: AUAHNF

4. Salagay O.O., Antonov N.S., Sakharova G.M. Analysis of trends in the consumption of tobacco and nicotine-containing products in the Russian Federation according to the results of online surveys 2019–2023. Russian Journal of Preventive Medicine. 2023; 26(5): 7–16 (In Russian). https://doi.org/10.17116/profmed2023260517. EDN: CEJDKE

5. Kirzhanova V.V. Epidemiology of alcoholism. Narcology: national guide / Еd. N.N. Ivanets, M.A. Vinnikova. 3rd ed., revised. and additional. Moscow: GEOTAR-Media, 2024. P. 40–49 (In Russian). https://doi.org/10.33029/9704-8363-3-NNG-2024-1-848. EDN: VZBGAV

6. Rotenstein L.S., Torre M., Ramos M.A., et al. Prevalence of Burnout Among Physicians: a Systematic Review. JAMA. 2018; 320(11): 1131-1150. https://doi.org/10.1001/jama.2018.12777

7. Mihailescu M., Neiterman E. As coping review of the literature on the current mental health status of physicians and physicians-in-training in North America. BMC Public Health. 2019; 19: 1363. https://doi.org/10.1186/s12889-019-7661-9

8. Mata D.A., Ramos M.A., Bansa l.N., et al. Prevalence of depression and depressive symptoms among resident physicians: a systematic review and meta-analysis. JAMA. 2015; 314(22): 2373–2383. https://doi.org/10.1001/jama.2015.15845

9. Marques-Pinto A., Moreira S., Costa-Lopes R., et al. Predictors of burnout among physicians: evidence from a national study in Portugal. Front Psychol. 2021; 12: 699974. https://doi.org/10.3389/fpsyg.2021.699974

10. Mingazov A.F., Lukomskiy I.S., Khabibullina L.R., Khomyakov E.A. Risk factors of burnout among physicians (results of public survey). Koloproktologia. 2022; 21(4): 60–67 (In Russian). https://doi.org/10.33878/2073-7556-2022-21-4-60-67. EDN: LQHFTR

11. Khalfin R.A., Madyanova V.V., Tuillet P.S., et al. Occupational burnout prevalence and associated factors among healthcare workers in Nizhny Novgorod region: The Foundation “VBlagodarnost” pilot program “Taking care of healthcare”. National Health Care (Russia). 2024; 5(1): 38–49 (In Russian). https://doi.org/10.47093/2713-069X.2024.5.1.38-49. EDN: AFTHCP

12. Alekseenko S.N., Gubarev S.V., Zubko A.V., et al. Alcohol consumption among medical students. Health care of the Russian Federation. 2024; 68(4): 323–330 (In Russian). https://doi.org/10.47470/0044-197X-2024-68-4-323-330. EDN: OLVAYC

13. Fadeeva E.V., Lanovaya A.M. Analysis of predictors of smoking and alcohol abuse among healthcare workers considering specialty and gender differences. National Health Care (Russia). 2024; 5(4): 27–37 (In Russian). https://doi.org/10.47093/2713-069X.2024.5.4.27-37. EDN: ALLJUF

14. McNeely J., Strauss S.M., Wright S., et al. Test-retest reliability of a self-administered Alcohol, Smoking and Substance Involvement Screening Test (ASSIST) in primary care patients. J Subst Abuse Treat. 2014; 47(1): 93–101. https://doi.org/10.1016/j. jsat.2014.01.007

15. Andrews G., Slade T. Interpreting scores on the Kessler Psychological Distress Scale (K10). Aust N Z J Public Health. 2001; 25(6): 494–497. https://doi.org/10.1111/j.1467-842x.2001.tb00310.x

16. Kessler R.C., Andrews G., Colpe L.J., et al. Short screening scales to monitor population prevalences and trends in non-specific psychological distress. Psychol Med. 2002; 32(6): 959–976. https://doi.org/10.1017/s0033291702006074. PMID: 12214795

17. Horowitz M., Wilner N., Alvarez W. Impact of Event Scale: a measure of subjective stress. Psychosom Med. 1979; 41(3): 209–218. https://doi.org/10.1097/00006842-197905000-00004

18. Weiss, D.S. (2007). The Impact of Event Scale: Revised. In: Wilson J.P., Tang C.Sk. (eds) Cross-Cultural Assessment of Psychological Trauma and PTSD. International and Cultural Psychology Series. Springer, Boston, MA. 2007. pp. 219–238. https://doi. org/10.1007/978-0-387-70990-1_10

19. Klimenko T.V., Korchagina G.A., Fadeeva E.V., Vyshinsky K.V. Design and methodology of studying the impact of the COVID-19 pandemic on patterns of psychoactive substance consumption. Issues of Narcology. 2021; 2(197): 74–99 (In Russian). https://doi. org/10.47877/0234-0623_2021_02_74. EDN: MVTFDF

20. Moya-Salazar J., Nuñez E., Jaime-Quispe A., et al. Substance Use in Healthcare Professionals During the COVID-19 Pandemic in Latin America: A Systematic Review and a Call for Reports. Subst Abuse. 2022; 16: 11782218221085592. https://doi. org/10.1177/11782218221085592

21. Martínez-Vélez N.A., Tiburcio M., Natera Rey G., et al. Psychoactive substance use and its relationship to stress, emotional state, depressive symptomatology, and perceived threat during the COVID-19 pandemic in Mexico. Front Public Health. 2021; 9: 709410. https://doi.org/10.3389/fpubh.2021.709410

22. Wei Y., Shah R.. Substance use disorder in the COVID-19 pandemic: a systematic review of vulnerabilities and complications. Pharmaceuticals. 2020; 13: 155. https://doi. org/10.3390/ph13070155

23. Valente J.Y., Sohi I., Garcia-Cerde R., et al. What is associated with the increased frequency of heavy episodic drinking during the COVID-19 pandemic? Data from the PAHO regional web-based survey. Drug Alcohol Depend. 2021; 221: 108621. https://doi. org/10.1016/j.drugalcdep.2021.108621

24. Mo D., Gluck R., Jiang F., et al. The association between mental health symptoms and alcohol use among Chinese psychiatrists during the early stage of the COVID-19 pandemic. Alcohol. 2024; 114: 1–7. https://doi.org/10.1016/j.alcohol.2023.0.006.