Department of Psychiatry, Recovery Research Institute, Massachusetts General Hospital, Harvard Medical School, Boston, MA.
Department of Psychiatry, Center for Anxiety and Traumatic Stress Disorders, Massachusetts General Hospital, Boston, MA.
Nicotine Tob Res. 2021 May 24;23(6):1038-1046. doi: 10.1093/ntr/ntaa166.
Most smoking cessation approaches are modeled on heavy daily smoking. With increasing prevalence of nondaily smoking, it may be necessary to modify these approaches for nondaily smokers.
To provide information about beliefs and attitudes relevant to smoking cessation for nondaily smokers.
Secondary analysis of two prospective studies on young adult smokers (18-24 years of age) provided brief advice to quit smoking. Measures include baseline levels of constructs relevant to smoking cessation counseling and perceived benefits of and barriers to smoking cessation.
Participants (n = 40 nondaily, 122 daily smokers) were predominantly White (70% and 84%, respectively), gender-balanced (50% and 43% female), full-time college students (89% and 95%). At baseline, nondaily smokers reported lower levels of nicotine dependence (p < .001; nondaily: Fagerström Test for Nicotine Dependence (FTND) = 0.8 ± 1.5, daily: FTND = 3.1 ± 1.9), lower urge to smoke (p < .001), greater self-efficacy when facing external smoking stimuli (p = .03), expecting to experience fewer positive effects (reduced negative affect, p = <.001, stimulation, p = .02), and valuing the importance of smoking effects less (ps < .01) than daily smokers. During counseling, nondaily smokers generated both fewer benefits of cessation (Wald X2(df = 1) = 4.91, p = .027) and fewer barriers (Wald X2(df = 1) = 5.99, p =.014) than daily smokers. Withdrawal was not listed by nondaily smokers as a barrier (p < .01).
Constructs relevant to smoking cessation for daily smokers were less salient to young nondaily smokers, compared with moderately addicted young daily smokers, as indicated by responses to standardized scales and by the generation of fewer benefits and barriers in counseling. Interventions may need to find novel ways to engage nondaily smokers, particularly young adult, in smoking cessation efforts.
This study is unique in eliciting benefits and barriers from nondaily smokers as they are about to make a quit attempt. This is a critically important point in time, as this is the point in time in which an action plan is formed and can be informed and enhanced by smoking cessation support. Our study further allowed direct comparison to daily smokers undergoing the same procedures, which allowed the identification of unique factors that may impact nondaily smokers in their quit attempt, which may guide intervention efforts. Use of a mixed method design further strengthen the rigor of this study.
大多数戒烟方法都是基于重度每日吸烟。随着非每日吸烟的流行,可能需要为非每日吸烟者修改这些方法。
为非每日吸烟者提供与戒烟相关的信念和态度信息。
对两项针对年轻成年吸烟者(18-24 岁)的前瞻性研究进行二次分析,为他们提供简短的戒烟建议。测量包括与戒烟咨询相关的结构的基线水平以及戒烟的益处和障碍感知。
参与者(40 名非每日吸烟者,122 名每日吸烟者)主要为白人(分别为 70%和 84%),性别均衡(分别为 50%和 43%为女性),全日制大学生(分别为 89%和 95%)。在基线时,非每日吸烟者报告的尼古丁依赖程度较低(p<0.001;非每日吸烟者:尼古丁依赖程度测试(FTND)=0.8±1.5,每日吸烟者:FTND=3.1±1.9),吸烟欲望较低(p<0.001),面对外部吸烟刺激时的自我效能感更高(p=0.03),预期体验到的益处较少(减少负面情绪,p<0.001,刺激,p=0.02),对吸烟影响的重视程度较低(p<0.01)与每日吸烟者相比。在咨询过程中,非每日吸烟者产生的戒烟益处(Wald X2(df=1)=4.91,p=0.027)和障碍(Wald X2(df=1)=5.99,p=0.014)都少于每日吸烟者。非每日吸烟者未将戒断列为障碍(p<0.01)。
与中度依赖的年轻每日吸烟者相比,年轻非每日吸烟者对与戒烟相关的结构不太敏感,这表明对标准化量表的反应以及在咨询中产生的益处和障碍较少。干预措施可能需要寻找新的方法来吸引非每日吸烟者,特别是年轻的成年吸烟者,参与戒烟努力。
本研究的独特之处在于,它从即将尝试戒烟的非每日吸烟者那里引出了益处和障碍。这是一个至关重要的时刻,因为此时会制定行动计划,并且可以通过戒烟支持来通知和增强该计划。我们的研究还允许与接受相同程序的每日吸烟者进行直接比较,这使我们能够确定可能影响非每日吸烟者戒烟尝试的独特因素,这可能为干预工作提供指导。使用混合方法设计进一步增强了这项研究的严谨性。