The credibility of evidence of various environmental risk factors for alcohol and tobacco use disorders (AUD/TUD) needs to be graded to identify groups to target with selective prevention. A systematic umbrella review was conducted (PubMed/PsycINFO), grading credibility of meta-analyses of prospective/retrospective observational cohort studies assessing risk/protective factors for AUD/TUD, applying established quantitative criteria. Sensitivity analyses were conducted. Quality of eligible meta-analyses was assessed with AMSTAR-2. Out of 8464 unique references, 80 full text articles were scrutinized, and 12 meta-analyses, corresponding to 21 individual estimates of 12 putative risk/protective factors (n = 241,300), were included. In main analyses no association had convincing nor highly suggestive evidence for AUD/TUD. Six associations had suggestive evidence for AUD, two for TUD. Among these, in sensitivity analyses without >1000 cases criterion, convincing evidence emerged for parental alcohol supply, and impulsivity traits in college students for AUD, and attention-deficit/hyperactivity disorder for TUD. Other associations were supported by weak evidence/were not nominally significant. Few risk factors identified at-risk groups where selective preventative strategies could be developed to prevent AUD/TUD.

需要对酒精和烟草使用障碍 (AUD/TUD) 的各种环境风险因素证据的可信度进行分级，以识别目标群体以进行选择性预防。进行了系统的综合审查 (PubMed/PsycINFO)，采用既定的定量标准，对评估 AUD/TUD 风险/保护因素的前瞻性/回顾性观察性队列研究的荟萃分析的可信度进行分级。进行了敏感性分析。符合条件的荟萃分析质量使用 AMSTAR-2 进行评估。在 8464 篇独特的参考文献中，对 80 篇全文文章进行了审查，并纳入了 12 篇荟萃分析，对应于对 12 个推定的风险/保护因素（n = 241,300）的 21 个个体估计。在主要分析中，没有任何关联具有令人信服或高度暗示的 AUD/TUD 证据。六个协会对 AUD 有提示性证据，两个对 TUD 有提示性证据。其中，在没有>1000个案例标准的敏感性分析中，出现了令人信服的证据表明父母酒精供应、大学生的AUD冲动特征和TUD注意力缺陷/多动障碍。其他关联得到微弱证据的支持/名义上并不显着。很少有风险因素确定了可以制定选择性预防策略来预防 AUD/TUD 的高危人群。