Ontario Tobacco Research Unit, University of Toronto, Toronto, Ontario, Canada.
Nicotine Tob Res. 2010 Aug;12(8):860-4. doi: 10.1093/ntr/ntq103. Epub 2010 Jul 2.
As smoking prevalence declines, some suggest that so-called "hardcore" smokers will come to represent a growing and irreducible proportion of current smokers ("hardening hypothesis"). Different definitions of a "hardcore" smoker have been used in the literature. This paper describes population-based definitions of "hardcore" smokers and compares estimates of the prevalence of "hardcore" smokers derived using these definitions.
Definitions identified in a comprehensive literature search were reduced to their component constructs. We estimated the prevalence of "hardcore" smokers as a proportion of all current adult smokers in Ontario, Canada, using data from the Ontario Tobacco Survey (2005-2008; N = 4,130). Definition concordance was examined using bivariate cross-tabulations.
Six definitions were identified in the literature. Five definitions included constructs of quit intentions and quit attempts, four included nicotine dependence, three included long-term use, and one included a measure of smoker knowledge about smoking hazards and confronting substantial societal disapprobation of smoking. Estimates of "hardcore" smoker prevalence in Ontario based on these definitions ranged from 0.03% to 13.77%.
Estimates of the prevalence of "hardcore" smokers in Ontario varied considerably between the six definitions of the "hardcore" smokers found in the population-based literature. This study underscores the need for consensus on the best definition of "hardcore" smoker.
随着吸烟率的下降，有人认为所谓的“铁杆”吸烟者将代表当前吸烟者中越来越大且不可减少的比例（“硬化假说”）。文献中使用了不同的“铁杆”吸烟者定义。本文描述了基于人群的“铁杆”吸烟者定义，并比较了使用这些定义得出的“铁杆”吸烟者患病率估计值。
从全面的文献检索中确定的定义被简化为其组成部分。我们使用加拿大安大略省烟草调查（2005-2008 年；N=4130）的数据，估计了“铁杆”吸烟者在安大略省所有成年当前吸烟者中的比例。使用双变量交叉表检查了定义的一致性。
文献中确定了六个定义。五个定义包括戒烟意图和戒烟尝试的结构，四个定义包括尼古丁依赖，三个定义包括长期使用，一个定义包括对吸烟危害的了解程度和对吸烟的强烈社会反对的衡量标准。基于这些定义，安大略省“铁杆”吸烟者患病率的估计值在 0.03%至 13.77%之间。
在基于人群的文献中发现的六个“铁杆”吸烟者定义中，安大略省“铁杆”吸烟者的患病率估计值差异很大。这项研究强调了就“铁杆”吸烟者的最佳定义达成共识的必要性。
