Psychology, West Virginia University, Morgantown, West Virginia, USA.
School of Medicine, University of Tasmania Faculty of Health, Hobart, Tasmania, Australia.
Tob Control. 2021 Jan;30(1):24-29. doi: 10.1136/tobaccocontrol-2019-055345. Epub 2020 Feb 12.
The concurrent use of cigarettes with other tobacco products, such as smokeless tobacco (SLT), is increasingly common. Extant work with cigarette smokers who also use SLT is based heavily on retrospective reports and between-group comparisons. The purpose of this study was to assess prospectively the patterns of dual users' product use and nicotine exposure on days when cigarettes were smoked exclusively (single use) versus concurrently with SLT (dual use).
Forty-six dual cigarette-SLT users recorded their product use in real time via ecological momentary assessment for a 2-week longitudinal design. They responded to questions about situational factors (eg, location, mood) using this same diary, and collected saliva samples each night for later cotinine measurement. At the end of this 2-week period, users reported on their reasons for and beliefs about SLT use.
Cotinine levels were significantly higher on dual versus single use days (mean±SEM=374.48±41.08 ng/mL vs 300.17±28.13 ng/mL, respectively; p<0.01), and the number of cigarettes logged was higher on dual versus single use days (11.13±0.98 vs 9.13±1.11, respectively; p<0.01). Product use was distinguished by situational factors, with the strongest predictor being location of use. Moreover, the most common reason for initiating (56.52%) and continuing (67.39%) SLT use was to circumvent indoor smoking restrictions.
Results support the idea of product supplementation rather than replacement among this convenience sample of dual users. For smokers whose primary motivation for SLT use involves situations where they would otherwise be tobacco free, the potential benefits of clean indoor air laws may be diminished.
香烟与其他烟草制品（如无烟烟草）同时使用的情况越来越普遍。目前针对既吸烟草又使用无烟烟草的烟民的研究工作主要基于回顾性报告和组间比较。本研究的目的是前瞻性地评估在仅吸烟草（单用时）与同时使用无烟烟草（双用时）时，双重使用者的产品使用模式和尼古丁暴露情况。
46 名双重使用香烟和无烟烟草的使用者通过生态瞬时评估（EMA）在 2 周的纵向设计中实时记录他们的产品使用情况。他们使用同一日记回答有关情境因素（例如，地点、情绪）的问题，并每天晚上收集唾液样本，以备日后进行可替宁测量。在这两周结束时，使用者报告了他们使用无烟烟草的原因和信念。
与单用时相比，双用时的可替宁水平显著更高（平均值±SEM 分别为 374.48±41.08ng/ml 和 300.17±28.13ng/ml，p<0.01），双用时记录的香烟数量也更多（分别为 11.13±0.98 支和 9.13±1.11 支，p<0.01）。产品使用情况因情境因素而有所不同，最强的预测因素是使用地点。此外，开始（56.52%）和继续（67.39%）使用无烟烟草的最常见原因是规避室内吸烟限制。
这些结果支持了便利性样本中的双重使用者产品补充而非替代的想法。对于那些主要出于无烟烟草可以在某些情况下避免吸烟的动机而使用无烟烟草的吸烟者来说，清洁室内空气法规的潜在好处可能会减少。
