University of Connecticut Health, School of Medicine, Farmington, CT.
University of Maryland, School of Public Health, Department of Behavioral and Community Health, Tobacco Center of Regulatory Science, College Park, MD.
Nicotine Tob Res. 2018 Aug 14;20(suppl_1):S12-S21. doi: 10.1093/ntr/nty061.
The dual use of cigarettes and cigars among African American young adults is a significant public health issue. Patterns of and reasons for dual use are difficult to capture using traditional self-report methods. This study used ecological momentary assessment (EMA) to characterize patterns of dual smoking and examine the personal and environmental predictors of cigarette and cigar smoking among African American young adult dual users (ages 18-29) in real-time.
For 14 days, 64 participants smoked ad libitum and were prompted four times daily to record their smoking, craving, emotions, social smoking, and environment via text message on their mobile phones. The odds of single product and dual use were examined using adjusted generalized estimating equations.
Participants smoked an average of 7.9 cigarettes and 4.2 cigars per day. Cigarettes and cigars were smoked as frequently during periods of dual use as they were during periods of single product use. Cigarette craving was positively associated with cigarette-only smoking (OR: 1.07), whereas cigar craving was positively associated with cigar-only smoking (OR: 1.43) and dual use (OR: 1.08). Cigars had the greatest odds of dual use when with others (OR: 4.69) and in others' homes (OR: 4.33). Cigarettes had the greatest odds of being smoked while alone (OR: 1.57).
EMA was useful for capturing variable smoking patterns and predictors. In this study population, cigarettes and cigars appeared to be smoked additively, and cigars smoked socially. These findings can inform future interventions addressing dual use in this high priority population.
This is the first study to use EMA to examine naturalistic patterns and predictors of multiple tobacco use in real-time. African American young adults smoked cigarettes and cigars during periods of dual use as frequently as during periods of single product use. This suggests that most use was additive (one product smoked in addition to another) and less often as substitution (one product smoked instead of another). Social smoking and craving were strongly associated with cigar smoking in single and dual use periods. This study suggests the need for cessation messaging specifically targeted to reduce dual use in this population.
香烟和雪茄在非裔美国年轻成年人中的双重使用是一个重大的公共卫生问题。使用传统的自我报告方法很难捕捉双重使用的模式和原因。本研究使用生态瞬时评估（EMA）实时描述双重吸烟模式，并研究个人和环境因素对非裔美国年轻成年双重使用者（18-29 岁）香烟和雪茄吸烟的预测作用。
在 14 天内，64 名参与者随意吸烟，并通过手机短信每天四次被提示记录吸烟、渴望、情绪、社交吸烟和环境。使用调整后的广义估计方程检查单一产品和双重使用的几率。
参与者平均每天吸 7.9 支香烟和 4.2 支雪茄。在双重使用期间，香烟和雪茄的吸烟频率与单一产品使用期间相同。香烟渴望与仅吸烟（OR：1.07）呈正相关，而雪茄渴望与仅吸烟（OR：1.43）和双重使用（OR：1.08）呈正相关。与他人一起吸烟（OR：4.69）和在他人家中吸烟（OR：4.33）时，雪茄的双重使用几率最大。独自吸烟时（OR：1.57），香烟的吸烟几率最大。
EMA 可用于捕捉变量吸烟模式和预测因素。在本研究人群中，香烟和雪茄似乎是叠加吸烟的，而且雪茄是在社交场合吸烟的。这些发现可以为针对这一高优先级人群的双重使用的未来干预措施提供信息。
这是第一项使用 EMA 实时检查多种烟草使用的自然模式和预测因素的研究。非裔美国年轻成年人在双重使用期间和单一产品使用期间一样频繁地吸烟和雪茄。这表明，大多数使用是叠加的（一种产品除另一种产品之外还吸烟），而不是替代的（一种产品代替另一种产品）。社交吸烟和渴望与单一和双重使用期间的雪茄吸烟密切相关。本研究表明，需要为该人群提供专门针对减少双重使用的戒烟信息。
