美国成年人 2012-2014 年多烟草使用与尼古丁依赖症状。
Polytobacco Use and Nicotine Dependence Symptoms Among US Adults, 2012-2014.
机构信息
Institute for Health & Aging, School of Nursing, University of California, San Francisco, CA.
Department of Clinical Pharmacy, School of Pharmacy, University of California, San Francisco, CA.
出版信息
Nicotine Tob Res. 2018 Aug 14;20(suppl_1):S88-S98. doi: 10.1093/ntr/nty050.
INTRODUCTION
The tobacco product landscape has changed substantially. Little is known about the recent pattern of polytobacco use (at least two tobacco products) among US adults and its relationship to nicotine dependence.
METHODS
Using the 2012-2013 and 2013-2014 National Adult Tobacco Survey (NATS) data (N = 135 425 adults), we analyzed the prevalence and correlates of polytobacco use among each of the six categories of current tobacco user (cigarettes, cigars, pipes, hookah, e-cigarettes, and smokeless tobacco). Based on five nicotine dependence symptom measures from the NATS, difference in the prevalence of dependence symptoms between polytobacco and sole-product users for each category of tobacco user was assessed using multivariable regression analyses.
RESULTS
During 2012-2014, 25.1% of adults were current users of any tobacco product. Among them, 32.5% were poly users with the largest poly use category being dual use of cigarettes and e-cigarettes (30.2%). Poly use prevalence was the lowest among current cigarette smokers (38.7%), followed by current users of smokeless tobacco (52.4%), hookah (59.2%), cigars (69.3%), e-cigarettes (80.9%), and pipes (86.2%). Among each category of current tobacco user, the prevalence of dependence symptom was consistently greater in polytobacco users than sole users for every symptom measure. After controlling for frequency of use and demographic covariates, the difference in nicotine dependence between poly users and sole users was statistically significant and consistent across all symptom measures for each category of tobacco user.
CONCLUSIONS
Between 52% and 86% of noncigarette tobacco users and nearly 40% of cigarette smokers engaged in polytobacco use. Poly users showed greater nicotine dependence than sole-product tobacco users.
IMPLICATIONS
This study examines recent patterns of polytobacco use separately for US adult current cigarette smokers, cigar smokers, pipe smokers, hookah users, e-cigarette users, and smokeless tobacco users. By including more tobacco products, particularly e-cigarettes and hookah, this study provides more comprehensive insight into polytobacco use. This study is also unique in comparing nicotine dependence between polytobacco and sole-product users among each category of tobacco users. Our results indicate that polytobacco use is very common and is associated with greater likelihood of reporting nicotine dependence symptoms. Tobacco cessation policies and programs should be tailored to address polytobacco use.
简介
烟草制品的种类已经发生了很大的变化。目前，人们对美国成年人最近的多烟草制品使用（至少两种烟草制品）模式及其与尼古丁依赖的关系知之甚少。
方法
利用 2012-2013 年和 2013-2014 年全国成人烟草调查（NATS）的数据（N=135425 名成年人），我们分析了当前使用每种烟草制品（香烟、雪茄、烟斗、水烟、电子烟和无烟烟草）的成年人中多烟草制品使用的流行率及其相关因素。基于 NATS 的五种尼古丁依赖症状测量指标，使用多变量回归分析评估了每种烟草制品使用者中多烟草制品使用者和单一产品使用者之间依赖症状的流行率差异。
结果
在 2012-2014 年期间，25.1%的成年人是任何烟草制品的当前使用者。其中，32.5%的人是多使用者，最大的多使用者类别是香烟和电子烟的双重使用者（30.2%）。多使用者的流行率在当前吸烟者中最低（38.7%），其次是当前使用无烟烟草制品者（52.4%）、水烟使用者（59.2%）、雪茄使用者（69.3%）、电子烟使用者（80.9%）和烟斗使用者（86.2%）。在每个当前烟草制品使用者类别中，在每个症状测量指标中，多使用者的依赖症状流行率都明显大于单一使用者。在控制使用频率和人口统计学协变量后，多使用者与单一使用者之间的尼古丁依赖差异在所有症状测量指标中均具有统计学意义且一致，适用于所有烟草制品使用者类别。
结论
在非香烟烟草制品使用者中，有 52%至 86%的人以及近 40%的香烟吸烟者存在多烟草制品使用行为。多使用者表现出比单一产品使用者更大的尼古丁依赖。
意义
本研究分别对美国成年当前吸烟者、雪茄烟民、烟斗烟民、水烟使用者、电子烟使用者和无烟烟草制品使用者的近期多烟草制品使用情况进行了研究。通过纳入更多的烟草制品，特别是电子烟和水烟，本研究对多烟草制品使用情况提供了更全面的了解。本研究的另一个独特之处在于比较了每个烟草制品使用者类别中多烟草制品使用者和单一产品使用者之间的尼古丁依赖程度。我们的结果表明，多烟草制品使用非常普遍，并且与更有可能报告尼古丁依赖症状相关。烟草控制政策和计划应针对多烟草制品使用进行调整。
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