与不吸电子烟的前吸烟者相比，吸电子烟的前吸烟者的吸烟依赖和复吸指标：来自 2016 年国际烟草控制四国吸烟与吸电子烟调查的结果。
Indicators of cigarette smoking dependence and relapse in former smokers who vape compared with those who do not: findings from the 2016 International Tobacco Control Four Country Smoking and Vaping Survey.
机构信息
Addictions Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
UK Centre for Tobacco & Alcohol Studies, UK.
出版信息
Addiction. 2019 Oct;114 Suppl 1(Suppl 1):49-60. doi: 10.1111/add.14722. Epub 2019 Aug 15.
BACKGROUND AND AIMS
It has been proposed that many smokers switch to vaping because their nicotine addiction makes this their only viable route out of smoking. We compared indicators of prior and current cigarette smoking dependence and of relapse in former smokers who were daily users of nicotine vaping products ('vapers') or who were not vaping at the time of survey ('non-vapers').
DESIGN
Cross-sectional survey-based comparison between vaping and non-vaping former smokers, including a weighted logistic regression of vaping status onto predictor variables, adjusting for covariates specified below.
SETTING
United States, Canada, Australia and England.
PARTICIPANTS
A total of 1070 people aged 18+ years from the 2016 International Tobacco Control (ITC) Four Country Smoking and Vaping Wave 1 Survey who reported having ever been daily smokers but who stopped less than 2 years ago and who were currently vapers or non-vapers.
MEASUREMENTS
Dependent variable was current vaping status. Predictor variables were self-reported: (1) smoking within 5 minutes of waking and usual daily cigarette consumption, both assessed retrospectively; (2) current perceived addiction to smoking, urges to smoke and confidence in staying quit. Covariates: country, sample sources, sex, age group, ethnicity, income, education, current nicotine replacement therapy use and time since quitting.
FINDINGS
Vapers were more likely than non-vapers to report: (1) having smoked within 5 minutes of waking [34.3 versus 15.9%, adjusted odds ratio (aOR) = 3.74, 95% confidence interval (CI) = 1.99, 7.03), χ = 16.92, P < 0.001]; having smoked > 10 cigarettes/day (74.4 versus 47.2%, aOR = 4.39, 95% CI = 2.22, 8.68), χ = 18.18, P < 0.001); (2) perceiving themselves to be still very addicted to smoking (41.3 versus 26.2%, aOR = 2.89, 95% CI = 1.58, 5.30, χ = 11.87, P < 0.001) and feeling extremely confident about staying quit (62.1 versus 36.6%, aOR = 3.22, 95% CI = 1.86, 5.59, χ = 17.36, P < 0.001). Vapers were not more likely to report any urges to smoke than non-vapers (27.7 versus 38.8%, aOR = 0.86, 95% CI = 0.44, 1.65, χ = 0.21, P = 0.643).
CONCLUSIONS
While former smokers who currently vape nicotine daily report higher levels of cigarette smoking dependence pre- and post-cessation compared with former smokers who are current non-vapers, they report greater confidence in staying quit and similar strength of urges to smoke.
背景和目的
有人提出，许多吸烟者转而使用电子烟，是因为他们的尼古丁成瘾使这成为他们戒烟的唯一可行途径。我们比较了每日使用尼古丁电子烟产品的前吸烟者（“电子烟使用者”）和当时未使用电子烟的前吸烟者（“非电子烟使用者”）的先前和当前吸烟依赖的指标，以及复吸的情况。
设计
电子烟使用者和非电子烟使用者的横断面调查比较，包括使用预测变量对电子烟使用状况进行加权逻辑回归，调整以下指定的协变量。
地点
美国、加拿大、澳大利亚和英国。
参与者
共有 1070 名年龄在 18 岁及以上的 2016 年国际烟草控制（ITC）四国吸烟和电子烟第 1 波调查的参与者，他们报告说曾经是每日吸烟者，但戒烟不到 2 年，目前是电子烟使用者或非电子烟使用者。
测量
因变量是当前的电子烟使用状况。预测变量为自我报告的：（1）醒来后 5 分钟内吸烟和通常每天吸烟量，均为回顾性评估；（2）目前对吸烟的成瘾程度、吸烟欲望和戒烟信心。协变量：国家、样本来源、性别、年龄组、种族、收入、教育程度、当前尼古丁替代疗法使用情况和戒烟时间。
发现
与非电子烟使用者相比，电子烟使用者更有可能报告：（1）醒来后 5 分钟内吸烟（34.3%比 15.9%，调整后的优势比[aOR]为 3.74，95%置信区间[CI]为 1.99，7.03），χ ²= 16.92，P < 0.001）；每天吸烟> 10 支（74.4%比 47.2%，aOR 为 4.39，95% CI 为 2.22，8.68），χ ²= 18.18，P < 0.001）；（2）认为自己仍然非常依赖吸烟（41.3%比 26.2%，aOR 为 2.89，95% CI 为 1.58，5.30），χ ²= 11.87，P < 0.001）；并对戒烟感到非常有信心（62.1%比 36.6%，aOR 为 3.22，95% CI 为 1.86，5.59），χ ²= 17.36，P < 0.001）。与非电子烟使用者相比，电子烟使用者报告的吸烟欲望并没有更强（27.7%比 38.8%，aOR 为 0.86，95% CI 为 0.44，1.65），χ ²= 0.21，P = 0.643）。
结论
虽然目前每天使用尼古丁电子烟的前吸烟者在戒烟前后的吸烟依赖程度高于目前不使用电子烟的前吸烟者，但他们对戒烟的信心更强，吸烟欲望的强度相似。
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