Centre de recherche du centre hopspitalier de l`Université de Montréal (CRCHUM), Montreal, QC, Canada.
Centre de recherche du centre hopspitalier de l`Université de Montréal (CRCHUM), Montreal, QC, Canada; Department of Social and Preventive Medicine, Université de Montréal, Montreal, QC, Canada.
Drug Alcohol Depend. 2019 Nov 1;204:107534. doi: 10.1016/j.drugalcdep.2019.06.036. Epub 2019 Aug 30.
Nicotine dependence (ND) symptoms can occur soon after first puff, so that stopping smoking becomes difficult well before 100 cigarettes lifetime is attained. Yet some surveillance systems do not monitor ND symptoms and 100-cigarettes lifetime is used in at least one surveillance system to define current smokers. To assess whether these features limit interpretation of grade-specific data in surveillance, we described smoking and ND symptoms across grade in incident vs. prevalent smokers, and in smokers according to 100-cigarettes lifetime.
Data were available in an investigation of 1294 grade 7 students from 10 Montreal-area high schools followed every 3 months from grade 7 to 11. Analyses described cigarette consumption, 100-cigarette lifetime consumption, cravings, withdrawal symptoms, mFTQ nicotine dependence and ICD-10 tobacco dependence by grade among past 3-month smokers.
Despite low cigarette consumption, 21-30% of grade 7 smokers reported ND symptoms. This increased to 27-44% in grade 8 and remained stable thereafter despite increased cigarette consumption. In grade 7, 10% of all smokers had not attained the 100-cigarette milestone but were already dependent. In grade 8, 9, 10 and 11, these proportions were 12%, 8%, 6% and 6%, respectively.
ND symptoms should be monitored in youth surveillance systems since they tell a different "story" than cigarettes and their appearance may represent a critical "point-of-no-return." Interventions for incident smokers are needed across grades to stop smoking before ND manifests. Without a shift in focus toward incident rather than established smokers, many children who try cigarettes will become addicted.
尼古丁依赖（ND）症状可能在首次吸烟后不久就会出现，因此，在达到终身吸烟 100 支之前，戒烟就变得非常困难。然而，一些监测系统并没有监测 ND 症状，并且至少有一个监测系统使用 100 支香烟终身来定义当前吸烟者。为了评估这些特征是否限制了监测中特定等级数据的解释，我们描述了在新吸烟者和现吸烟者中，以及根据 100 支香烟终身吸烟的吸烟者中，吸烟和 ND 症状在各等级之间的情况。
这项研究的数据来自对 10 所蒙特利尔地区高中的 1294 名 7 年级学生进行的一项调查，这些学生从 7 年级到 11 年级每 3 个月接受一次随访。分析描述了过去 3 个月吸烟的学生中，各年级的香烟消费、100 支香烟终身消费、烟瘾、戒断症状、mFTQ 尼古丁依赖和 ICD-10 烟草依赖情况。
尽管香烟消费量较低，但仍有 21-30%的 7 年级吸烟者报告出现 ND 症状。这一比例在 8 年级上升到 27-44%，此后尽管香烟消费量增加，但仍保持稳定。在 7 年级，10%的所有吸烟者尚未达到 100 支香烟的里程碑，但已经依赖吸烟。在 8 年级、9 年级、10 年级和 11 年级，这些比例分别为 12%、8%、6%和 6%。
在青少年监测系统中应该监测 ND 症状，因为它们与香烟的情况不同，并且它们的出现可能代表了一个关键的“不归点”。需要在各年级为新吸烟者提供干预措施，以阻止他们在出现 ND 症状之前吸烟。如果不将重点转向新吸烟者而不是已吸烟者，许多尝试吸烟的儿童将成瘾。
