Department of Public Health Sciences, Karolinska Institute, Stockholm, Sweden.
Addiction. 2010 Apr;105(4):740-6. doi: 10.1111/j.1360-0443.2009.02852.x. Epub 2010 Feb 9.
AIMS: To determine whether symptoms of nicotine dependence, addiction and withdrawal symptoms differ between exclusive smokers, exclusive snus (moist snuff) users and dual users. DESIGN: A cross-sectional survey of a cohort subsample. Setting County of Stockholm, Sweden. PARTICIPANTS: Current exclusive smokers (n = 466), exclusive snus users (n = 209) and dual users (n = 144), mean age 17.6 years. MEASUREMENTS: Self-reported life-time experience of nicotine dependence and withdrawal symptoms in periods of discontinued tobacco use. Selected items from the modified Fagerstöm Tolerance Questionnaire (mFTQ), the Hooked on Nicotine Checklist (HONC) and the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV). FINDINGS: The odds ratio of endorsing each of four mFTQ items as well as the HONC item investigating the risk of feeling addicted to tobacco was two to five-fold higher for exclusive snus users and for dual users compared to exclusive smokers. One DSM-IV item (difficult to refrain from use) was elevated among dual users compared to smokers. Dual users reported the highest prevalence of any withdrawal symptom in contrast to exclusive snus users, who reported a lower risk of withdrawal symptoms compared to exclusive smokers. CONCLUSIONS: Smokeless tobacco users show symptoms of nicotine dependence at least as frequently as cigarette smokers. Symptoms of nicotine dependence and of withdrawal during quit attempts are particularly frequent in the subgroup of users who combine smokeless tobacco with smoking.
目的:确定尼古丁依赖、成瘾和戒断症状在只吸烟、只使用鼻烟(湿鼻烟)和双重使用者之间是否存在差异。
设计:对队列子样本进行横断面调查。地点:瑞典斯德哥尔摩县。
参与者:当前只吸烟(n=466)、只使用鼻烟(n=209)和双重使用者(n=144),平均年龄为 17.6 岁。
测量:自我报告的一生中在停止使用烟草时的尼古丁依赖和戒断症状的经历。从改良的 Fagerström 耐受性问卷(mFTQ)、尼古丁成瘾检查表(HONC)和精神障碍诊断与统计手册(DSM-IV)中选择的项目。
结果:与只吸烟者相比,只使用鼻烟者和双重使用者对四个 mFTQ 项目中的每一个以及调查对烟草成瘾风险的 HONC 项目的赞同率是两倍到五倍。与吸烟者相比,双重使用者在 DSM-IV 项目(难以克制使用)中表现出更高的发生率。与只使用鼻烟者相比,双重使用者报告了更高的任何戒断症状的发生率,而只使用鼻烟者报告的戒断症状的风险低于只吸烟者。
结论:无烟火草使用者表现出的尼古丁依赖症状至少与吸烟者一样频繁。在同时使用无烟烟草和吸烟的使用者亚组中,尼古丁依赖和戒烟尝试期间戒断的症状特别频繁。
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