Department of Epidemiology and Biostatistics, Memorial Sloan-Kettering Cancer Center, New York, NY 10021, USA.
Nicotine Tob Res. 2013 Feb;15(2):509-17. doi: 10.1093/ntr/nts180. Epub 2012 Sep 4.
Studies suggest that initial smoking pleasure influences future smoking behavior. We investigated how initial reactions to cigarettes or Swedish smokeless tobacco (snus) were associated with future use among 10,708 adults from the Swedish Twin Registry.
The Early Smoking Experience questionnaire captured physiologic reactions to initial tobacco use. Binary recursive partitioning (BRP) identified combinations of initial reactions predictive of regular tobacco use. Analyses, stratified by sex, were conducted separately among those who experimented with only cigarettes (EC), only snus (ES), and both products (EC+S).
Among EC, 39.8% of men and 43.7% of women became smokers, while among ES, 78.6% of men and 53.7% of women became snus users. Among EC+S, 31.3% of men and 20.0% of women became dual users. BRP identified different reactions as predictive of future smoking for men (buzz) and women (dizziness, difficulty inhaling). No initial reaction predicted future snus use among men, but pleasant sensations, later age at first use, and relaxation predicted future snus use for women. Among EC+S, future exclusive use of either product was associated with a favorable initial reaction to that product. Dual users experienced higher prevalence of pleasant reactions and lower prevalence of unpleasant reactions in response to both products.
Our findings support that those who progress to regular tobacco use may be sensitive to the rewarding effects of nicotine but suggest that initial reactions differ by tobacco type. A high proportion of men became regular snus users regardless of initial reactions.
研究表明，最初的吸烟愉悦感会影响未来的吸烟行为。我们调查了瑞典双胞胎登记处的 10708 名成年人中，最初对香烟或瑞典无烟烟草（鼻烟）的反应与未来使用之间的关系。
早期吸烟体验问卷捕捉了对初始吸烟的生理反应。二元递归分区（BRP）确定了可预测常规烟草使用的初始反应组合。根据仅吸烟（EC）、仅鼻烟（ES）和两者都使用（EC+S）的情况，对男性和女性分别进行分层分析。
在 EC 中，39.8%的男性和 43.7%的女性成为吸烟者，而在 ES 中，78.6%的男性和 53.7%的女性成为鼻烟使用者。在 EC+S 中，31.3%的男性和 20.0%的女性成为双重使用者。BRP 确定了不同的反应，这些反应对男性（兴奋）和女性（头晕、呼吸困难）的未来吸烟有预测作用。没有初始反应预测男性未来使用鼻烟，但女性的愉快感觉、首次使用年龄较晚和放松状态预测了未来使用鼻烟。在 EC+S 中，未来对任何一种产品的独家使用都与对该产品的良好初始反应有关。与仅使用一种产品的使用者相比，双重使用者在对两种产品的反应中，愉快反应的发生率更高，不愉快反应的发生率更低。
我们的研究结果支持了那些发展为常规烟草使用者的人可能对尼古丁的奖赏效应敏感，但也表明初始反应因烟草类型而异。相当多的男性无论初始反应如何，都成为了常规鼻烟使用者。
