Faculty of Medicine, School of Public Health, The University of Queensland, Herston, Australia.
Nicotine Tob Res. 2018 Aug 14;20(9):1038-1046. doi: 10.1093/ntr/ntx186.
Despite the centrality of addiction in academic accounts of smoking, there is little research on smokers' beliefs about addiction to smoking, and the role of nicotine in tobacco dependence. Smokers' perspectives on nicotine's role in addiction are important given the increasing prevalence of nontobacco nicotine products such as e-cigarettes. We conducted a systematic review of studies investigating smokers' understandings and lay beliefs about addiction to smoking and nicotine.
We searched PubMed, Embase, CINAHL, and PsycINFO for studies investigating lay beliefs about addiction to smoking. Twenty-two quantitative and 24 qualitative studies met inclusion criteria. Critical interpretive synthesis was used to analyze the results.
Very few studies asked about addiction to nicotine. Quantitative studies that asked about addiction to smoking showed that most smokers believe that cigarettes are an addictive product, and that they are addicted to smoking. Across qualitative studies, nicotine was not often mentioned by participants. Addiction to smoking was most often characterized as a feeling of "need" for cigarettes resulting from an interplay between physical, mental, and social processes. Overall, we found that understandings of smoking were more consistent with the biopsychosocial model of addiction than with more recent models that emphasize the biological aspects of addiction.
Researchers should not treat perceptions of addiction to smoking interchangeably with perceptions of addiction to nicotine. More research on lay beliefs about nicotine is required, particularly considering the increasing use of e-cigarettes and their potential for long-term nicotine maintenance for harm reduction.
Quantitative studies show that most smokers believe that smoking is addictive and that they are addicted. A feeling of "need" for cigarettes was central to qualitative accounts of addiction, but nicotine was not often discussed. Overall, smokers' understandings of addiction reflect a biopsychosocial model rather than a neurobiological one. Given the growing market for e-cigarettes and therapeutic nicotine, more research is required on lay beliefs about nicotine and addiction.
尽管成瘾在学术上对吸烟的描述中占据核心地位，但关于吸烟者对吸烟成瘾和尼古丁在烟草依赖中的作用的看法的研究却很少。鉴于非烟草尼古丁产品（如电子烟）的流行率不断上升，吸烟者对尼古丁在成瘾中的作用的看法非常重要。我们对调查吸烟者对吸烟成瘾和尼古丁的理解和基本信念的研究进行了系统回顾。
我们在 PubMed、Embase、CINAHL 和 PsycINFO 中搜索了调查吸烟成瘾的基本信念的研究。符合纳入标准的有 22 项定量研究和 24 项定性研究。使用批判性解释性综合分析来分析结果。
很少有研究询问尼古丁成瘾。询问吸烟成瘾的定量研究表明，大多数吸烟者认为香烟是一种成瘾产品，并且他们对吸烟成瘾。在定性研究中，参与者很少提到尼古丁。吸烟成瘾通常被描述为由于生理、心理和社会过程相互作用而对香烟产生“需要”的感觉。总的来说，我们发现对吸烟的理解与成瘾的生物心理社会模型更一致，而与强调成瘾的生物学方面的最新模型不一致。
研究人员不应该将对吸烟成瘾的看法与对尼古丁成瘾的看法混为一谈。需要对关于尼古丁的基本信念进行更多研究，特别是考虑到电子烟的使用越来越多及其作为减少伤害的长期维持尼古丁的潜力。
定量研究表明，大多数吸烟者认为吸烟成瘾，而且他们对尼古丁也成瘾。对香烟的“需要”的感觉是定性成瘾描述的核心，但尼古丁却很少被讨论。总的来说，吸烟者对成瘾的理解反映了一种生物心理社会模型，而不是神经生物学模型。鉴于电子烟和治疗性尼古丁市场的不断增长，需要对关于尼古丁和成瘾的基本信念进行更多研究。
