Rutgers Center for Tobacco Studies, Rutgers Biomedical and Health Sciences, 303 George Street Suite 500, New Brunswick, NJ 08901, USA; Department of Health Behavior, Society and Policy, Rutgers School of Public Health, 683 Hoes Lane W, Piscataway, NJ 08854, USA.
Health Promotion Research Center, University of Oklahoma Health Sciences Center, 655 Research Parkway, Suite400, Oklahoma City, OK 73104, USA; Department of Pediatrics, University of Oklahoma Health Sciences Center, College of Medicine, Oklahoma City, OK, 73104, USA.
Addict Behav. 2022 Feb;125:107162. doi: 10.1016/j.addbeh.2021.107162. Epub 2021 Oct 26.
Tobacco use remains disproportionately common among adults with internalizing problems. The rising prevalence of flavored tobacco use among this population may be a contributing factor. Using data from Wave 4 of the Population Assessment of Tobacco and Health Study, this study examined differences across adult ever tobacco users by severity of internalizing problems, in initiation of tobacco use with a flavored product and past 30-day (current) flavored tobacco use (n = 27,425). Severity of internalizing problems was measured using the Global Appraisal of Individual Needs-Short Screener Internalizing Disorder Screener. Tobacco use variables included initiation with or current use of a flavored product, assessed separately for each product. Weighted chi-square tests and multivariable modified Poisson regression models were used to examine the associations between severity of internalizing problems and each outcome.
Controlling for covariates, ever users with severe internalizing problems were more likely to have initiated with flavors for cigarettes (adjusted prevalence ratio [aPR]: 1.16, 95% confidence interval [CI]: 1.09,1.24), cigarillos (aPR: 1.09, 95% CI: 1.03, 1.16), electronic nicotine products (aPR: 1.08, 95% CI: 1.03, 1.13) and smokeless tobacco (aPR: 1.15, 95% CI: 1.04, 1.27), relative to those with low internalizing problems. Ever users with severe internalizing problems were more likely to currently use a flavored tobacco product for cigarettes (aPR: 1.15, 95% CI: 1.07, 1.24) and cigarillos (aPR: 1.15, 95% CI: 1.04, 1.28).
Flavored tobacco use seems disproportionately common among tobacco users with severe internalizing problems, across a variety of measures.
有内化问题的成年人中，吸烟仍然普遍存在且不成比例。这一人群中调味烟草使用的流行率上升可能是一个促成因素。本研究利用来自《人口烟草与健康评估研究》第四波的数据，根据内化问题严重程度，分析了成年曾用烟草者在使用调味产品开始吸烟和过去 30 天（当前）使用调味烟草（n=27425）方面的差异。内化问题的严重程度使用全球个体需求评估-短筛查内化障碍筛查器进行测量。烟草使用变量包括使用调味产品的开始使用和当前使用，每种产品都单独评估。使用加权卡方检验和多变量修正泊松回归模型来检验内化问题严重程度与每种结局之间的关联。
在控制了协变量后，有严重内化问题的曾用烟草者更有可能开始使用调味香烟（调整后的患病率比[aPR]：1.16，95%置信区间[CI]：1.09，1.24）、小雪茄（aPR：1.09，95% CI：1.03，1.16）、电子烟（aPR：1.08，95% CI：1.03，1.13）和无烟烟草（aPR：1.15，95% CI：1.04，1.27），与内化问题较轻的人相比。有严重内化问题的曾用烟草者更有可能当前使用调味烟草制品吸烟（aPR：1.15，95% CI：1.07，1.24）和小雪茄（aPR：1.15，95% CI：1.04，1.28）。
在各种措施中，调味烟草的使用在有严重内化问题的烟草使用者中似乎不成比例地更为常见。
