Laboratory of Hygiene and Epidemiology, Faculty of Medicine, University of Thessaly, 41222 Larissa, Greece.
Healthcare Management Program, Faculty of Economics and Management, Open University of Cyprus, Nicosia 2210, Cyprus.
Int J Environ Res Public Health. 2020 Nov 5;17(21):8191. doi: 10.3390/ijerph17218191.
Nicotine dependence is one of the main reasons for the continuation of smoking among adolescents. Loss of autonomy (LOA) is a measure of dependence. This study is the first to investigate LOA and its determinants among Greek adolescents. In 2013, 13-to-15-year-old middle-school students were selected by multi-stage clustered sampling. LOA was evaluated with the Hooked-on-Nicotine Checklist (HONC). Multiple univariate analysis was used to assess the association between adolescent demographics, smoking habits, and loss of autonomy. Three-hundred thirty-nine current smokers responded to the questionnaire (response rate: 82.3%). Of these respondents, 51.2% were male and 88.8% reported at least one LOA symptom. The mean HONC score was 4.13/10 (95% CI: 3.82-4.45). Higher scores were negatively associated with lower smoking frequency (cumulative odds ratio (cOR): 0.240, 95% CI: 0.144-0.400) and positively associated with lower age at first cigarette (cOR: 2.29, 95% CI: 1.38-3.82). Female gender was significantly associated with the prevalence but not the degree of LOA. Overall, the prevalence and the degree of nicotine dependence among adolescent smokers in Greece is similar to other countries. Frequent smoking and initiation of smoking at a younger age are linked to nicotine dependence, although it was not possible to make causal inferences. The relationship between nicotine dependence and gender remains unclear.
尼古丁依赖是青少年继续吸烟的主要原因之一。自主性丧失（LOA）是依赖性的一种衡量标准。这项研究首次调查了希腊青少年的 LOA 及其决定因素。2013 年，通过多阶段聚类抽样选择了 13 至 15 岁的中学生。使用尼古丁依赖检查表（HONC）评估 LOA。采用单变量分析评估青少年人口统计学特征、吸烟习惯与自主性丧失之间的关系。共有 339 名当前吸烟者回答了问卷（应答率：82.3%）。这些应答者中，51.2%为男性，88.8%报告至少有一种 LOA 症状。HONC 平均得分为 4.13/10（95%CI：3.82-4.45）。较高的分数与较低的吸烟频率呈负相关（累积比值比（cOR）：0.240，95%CI：0.144-0.400），与首次吸烟年龄较小呈正相关（cOR：2.29，95%CI：1.38-3.82）。女性性别与 LOA 的患病率显著相关，但与 LOA 的严重程度无关。总体而言，希腊青少年吸烟者的尼古丁依赖患病率和严重程度与其他国家相似。频繁吸烟和较早开始吸烟与尼古丁依赖有关，尽管无法做出因果推断。尼古丁依赖与性别之间的关系仍不清楚。
