Nguyen Nhung, Kapiteni Kwinoja, Straus Elana R, Guydish Joseph
Center for Tobacco Control Research and Education, Division of General Internal Medicine, University of California, San Francisco, California, USA.
Philip R. Lee Institute for Health Policy Studies, School of Medicine, University of California, San Francisco, California, USA.
Am J Addict. 2021 Sep;30(5):496-504. doi: 10.1111/ajad.13206. Epub 2021 Aug 23.
Little is known about whether people in substance use disorder (SUD) treatment are at risk for multiple-tobacco use. We examined the factors associated with dual- and polytobacco use among clients in SUD treatment.
A cross-sectional survey was conducted in 2019 among 562 clients (M = 39, 74% male) in 20 residential SUD treatment programs in California, USA. The outcomes included single-, dual- (use of two products), and polytobacco use (use of three of more products). Independent variables were nicotine dependence, quitting-related factors, blunt/spliff use, and health-related factors. A multinomial model examined associations between the independent variables and the outcome, controlling for demographics, and time in treatment.
Overall, 32.6%, 18.9%, and 14.0% of the sample were single-, dual-, and polytobacco users, respectively. Factors associated with increased odds of polytobacco use included greater nicotine dependence (adjusted odds ratio [AOR] = 1.60; 95% CI = 1.19, 2.16), ever using e-cigarettes for quitting (AOR = 4.56; 95% CI = 2.23, 9.34), and past 30-day use of blunt/spliff (AOR = 2.96; 95% CI = 1.48, 5.89). Factors associated with increased odds of dual use were ever using e-cigarettes for quitting (AOR = 3.19; 95% CI = 1.79, 5.66) and reporting more mentally unhealthy days (AOR = 1.05; 95% CI = 1.02, 1.07).
This study extends the literature on tobacco use among people in SUD treatment by revealing the high prevalence of dual- and polytobacco use and the unique characteristics of users. The findings have implications for interventions reducing all types of tobacco use in this understudied population.
对于物质使用障碍（SUD）治疗中的人群是否存在多种烟草使用风险，人们了解甚少。我们研究了SUD治疗中患者双重和多种烟草使用的相关因素。
2019年对美国加利福尼亚州20个住院SUD治疗项目中的562名患者（平均年龄39岁，74%为男性）进行了横断面调查。结果包括单一烟草使用、双重（使用两种产品）和多种烟草使用（使用三种或更多产品）。自变量为尼古丁依赖、戒烟相关因素、吸食大麻烟/大麻卷烟情况以及健康相关因素。采用多项模型研究自变量与结果之间的关联，并对人口统计学和治疗时间进行了控制。
总体而言，样本中分别有32.6%、18.9%和14.0%的人使用单一烟草、双重烟草和多种烟草。与多种烟草使用几率增加相关的因素包括更高的尼古丁依赖（调整后的优势比[AOR]=1.60；95%置信区间[CI]=1.19，2.16）、曾使用电子烟戒烟（AOR=4.56；95%CI=2.23，9.34）以及过去30天内吸食大麻烟/大麻卷烟（AOR=2.96；95%CI=1.48，5.89）。与双重使用几率增加相关的因素是曾使用电子烟戒烟（AOR=3.19；95%CI=1.79，5.66）以及报告更多心理健康不佳的天数（AOR=1.05；95%CI=1.02，1.07）。
本研究通过揭示双重和多种烟草使用的高患病率以及使用者的独特特征，扩展了关于SUD治疗人群烟草使用的文献。这些发现对减少这一研究不足人群中所有类型烟草使用的干预措施具有启示意义。
