Haddock C K, Weg M V, DeBon M, Klesges R C, Talcott G W, Lando H, Peterson A
University of Missouri, Kansas City, Missouri 64110, USA.
Prev Med. 2001 Mar;32(3):262-7. doi: 10.1006/pmed.2000.0802.
This study was designed to test the hypothesis that smokeless tobacco (SLT) serves as a gateway drug for smoking among young adult males. Methods. A cohort (n = 7,865) of U.S. Air Force recruits who claimed to have never smoked cigarettes was followed prospectively for 1 year. The participants were male, 32.9% were ethnic minorities, and their average age was 19.84 years (SD = 2.29). Among recruits entering basic military training, 403 (5.1%) reported current SLT use and 198 (2.5%) reported a past history of SLT use.
At the 1-year follow-up current SLT users were 233% more likely to have initiated smoking than nonusers (odds ratio = 2.33, 95% CI = 1.84-2.94). Similarly, recruits who reported past SLT use were 227% more likely to begin smoking than participants who had never used SLT (odds ratio = 2.27, 95% CI = 1.64-3.15). SLT use remained a potent predictor of smoking initiation in a multivariate logistic model that included demographic factors and other risk factors for initiation.
SLT use appears to be an important predictor of smoking initiation among young adult males. This study suggests that smoking prevention and cessation programs should also include strategies related to SLT use.
本研究旨在验证无烟烟草（SLT）是年轻成年男性吸烟的入门药物这一假设。方法。对一组自称从未吸过香烟的美国空军新兵（n = 7865）进行了为期1年的前瞻性跟踪。参与者为男性，32.9%为少数民族，平均年龄为19.84岁（标准差 = 2.29）。在进入基础军事训练的新兵中，403人（5.1%）报告目前使用SLT，198人（2.5%）报告有SLT使用史。
在1年的随访中，目前使用SLT的人开始吸烟的可能性比不使用者高233%（优势比 = 2.33，95%置信区间 = 1.84 - 2.94）。同样，报告有过SLT使用史的新兵开始吸烟的可能性比从未使用过SLT的参与者高227%（优势比 = 2.27，95%置信区间 = 1.64 - 3.15）。在包含人口统计学因素和其他开始吸烟风险因素的多变量逻辑模型中，SLT使用仍然是开始吸烟的有力预测因素。
SLT使用似乎是年轻成年男性开始吸烟的重要预测因素。这项研究表明，吸烟预防和戒烟项目也应包括与SLT使用相关的策略。
