Pennanen Marjaana, Broms Ulla, Korhonen Tellervo, Haukkala Ari, Partonen Timo, Tuulio-Henriksson Annamari, Laatikainen Tiina, Patja Kristiina, Kaprio Jaakko
Hjelt Institute, Department of Public Health, University of Helsinki, P.O. Box 41, Mannerheimintie 172, 00014 Helsinki, Finland; National Institute for Health and Welfare, P.O. Box 30, Mannerheimintie 166, FI-00271 Helsinki, Finland; Health and Social Services Department, Municipality of Askola, Askolantie 30, FI-07500 Askola, Finland.
Hjelt Institute, Department of Public Health, University of Helsinki, P.O. Box 41, Mannerheimintie 172, 00014 Helsinki, Finland; National Institute for Health and Welfare, P.O. Box 30, Mannerheimintie 166, FI-00271 Helsinki, Finland.
Addict Behav. 2014 Jul;39(7):1145-51. doi: 10.1016/j.addbeh.2014.03.005. Epub 2014 Mar 13.
Low socio-economic status (SES) is strongly related to smoking, but studies examining the association of SES with nicotine dependence (ND) are scarce. The aim of this study was to examine the associations of SES and marital status with smoking, multiple measures of ND, and cotinine as a nicotine intake biomarker.
The sample comprised 1746 ever smokers, sampled from the National FINRISK 2007 Study, who had completed a tobacco specific questionnaire in addition to the standard clinical examination. The Fagerström Test for Nicotine Dependence (FTND), the Heaviness of Smoking Index (HSI), the Nicotine Dependence Syndrome Scale (NDSS), and the Hooked On Nicotine Checklist (HONC) were assessed, while plasma cotinine was measured as a biomarker of nicotine exposure in daily smokers. Univariate and multivariate associations were assessed by linear regression and multinomial logistic regression.
In multivariate models, lower education was associated with higher FTND and HSI, income with HSI, and occupation with HSI (men only), FTND, HONC and NDSS scores. Lower education was related to higher cotinine levels among daily smokers, although the association diminished slightly after adjusting for daily smoking amount. Living without a spouse was associated with daily smoking and higher ND.
In this cross-sectional study low SES was linked with higher ND among current smokers, while low SES was associated with higher cotinine levels among daily smokers. Living alone was linked with higher ND. Longitudinal studies are warranted to further explore these associations. As lower SES smokers are more addicted they may need more targeted cessation services to succeed in quitting smoking.
社会经济地位低下（SES）与吸烟密切相关，但研究SES与尼古丁依赖（ND）之间关联的研究却很少。本研究的目的是探讨SES和婚姻状况与吸烟、多种尼古丁依赖测量指标以及作为尼古丁摄入生物标志物的可替宁之间的关联。
样本包括从2007年全国芬兰风险研究中抽取的1746名曾经吸烟的人，他们除了完成标准临床检查外，还填写了一份烟草专项问卷。评估了尼古丁依赖的法格斯特伦测试（FTND）、吸烟严重程度指数（HSI）、尼古丁依赖综合征量表（NDSS）和尼古丁上瘾清单（HONC），同时测量了血浆可替宁作为日常吸烟者尼古丁暴露的生物标志物。通过线性回归和多项逻辑回归评估单变量和多变量关联。
在多变量模型中，较低的教育程度与较高的FTND和HSI相关，收入与HSI相关，职业与HSI（仅男性）、FTND、HONC和NDSS得分相关。较低的教育程度与日常吸烟者中较高的可替宁水平相关，尽管在调整每日吸烟量后这种关联略有减弱。没有配偶生活与每日吸烟和较高的尼古丁依赖相关。
在这项横断面研究中，低SES与当前吸烟者中较高的尼古丁依赖相关，而低SES与日常吸烟者中较高的可替宁水平相关。独居与较高的尼古丁依赖相关。有必要进行纵向研究以进一步探索这些关联。由于低SES吸烟者成瘾性更强，他们可能需要更有针对性的戒烟服务才能成功戒烟。
