Department of Public Health Sciences, Penn State College of Medicine, Center for Research on Tobacco and Health, Hershey, PA 17033, USA.
College of Nursing, University of Wisconsin-Milwaukee, Milwaukee, WI 53211, USA.
Nicotine Tob Res. 2023 Feb 9;25(3):372-378. doi: 10.1093/ntr/ntac153.
How nicotine dependence will be affected when current smokers initiate electronic cigarette (e-cigarette) use to reduce cigarette smoking is unknown. This study evaluated cigarette, e-cigarette, and total nicotine dependence more than 6 months among smokers reducing cigarette consumption by replacing with e-cigarettes.
Adult cigarette smokers were randomized to one of four conditions (36 mg/ml e-cigarette, 8 mg/ml e-cigarette, 0 mg/ml e-cigarette, or cigarette-substitute [CS] [provided at no cost]) and instructed to reduce their cigarette smoking by 75% at 1 month. Participants completed follow-up at 1, 3, and 6 months. The Penn State Nicotine Dependence Index (PSNDI) measured dependence on cigarettes (PSCDI) and e-cigarettes (PSECDI). Urine cotinine measured total nicotine exposure. Linear mixed effects models for each outcome were conducted and included interaction terms between visit and condition.
Participants (n = 520) were 58.8% female, 67.3% White, and 48.0 years old. At baseline, the median number of cigarettes smoked per day was 17.3 and the mean PSCDI score was 13.4, with no significant differences between conditions. Participants in the e-cigarette conditions reported significantly lower PSCDI scores, compared with baseline, and with the CS condition at all follow-up visits. Those in the 36 mg/ml e-cigarette condition reported greater PSECDI scores at 6 months, compared with baseline and the 0 mg/ml and 8 mg/ml conditions. At all follow-up visits, there were no differences in total nicotine exposure compared to baseline, nor between any conditions.
E-cigarette use was associated with reduced cigarette dependence, compared to the CS, without significant increases in total nicotine exposure.
Initiation of electronic cigarette use while continuing to smoke could potentially increase nicotine dependence. In this randomized trial aimed at helping smokers to reduce their cigarette intake, we found that use of an e-cigarette was associated with a reduction in cigarette dependence and an increase in e-cigarette dependence (in the condition with the highest nicotine concentration only), with no long term increase in total nicotine dependence or nicotine exposure.
目前尚不清楚当前吸烟者开始使用电子烟（电子烟）以减少吸烟量时，尼古丁依赖会受到怎样的影响。本研究评估了在通过电子烟替代香烟减少吸烟量的吸烟者中，超过 6 个月的香烟、电子烟和总尼古丁依赖情况。
成年香烟吸烟者被随机分配到以下四种条件之一（36 毫克/毫升电子烟、8 毫克/毫升电子烟、0 毫克/毫升电子烟或香烟替代品[CS] [免费提供]），并被指示在 1 个月内将吸烟量减少 75%。参与者在 1、3 和 6 个月时完成随访。宾夕法尼亚州尼古丁依赖指数（PSNDI）测量香烟（PSCDI）和电子烟（PSECDI）的依赖程度。尿液可替宁测量总尼古丁暴露量。对每个结果进行线性混合效应模型分析，并包括访视和条件之间的交互项。
参与者（n=520）中 58.8%为女性，67.3%为白人，48.0 岁。基线时，每天吸烟的中位数为 17.3 支，PSCDI 得分平均为 13.4，各条件之间无显著差异。与基线相比，电子烟条件下的参与者报告的 PSCDI 评分显著降低，与 CS 条件相比，在所有随访时均如此。与 0 毫克/毫升和 8 毫克/毫升条件相比，36 毫克/毫升电子烟条件下的参与者在 6 个月时报告的 PSECDI 评分更高。在所有随访时，与基线相比，总尼古丁暴露量没有差异，也没有任何条件之间的差异。
与 CS 相比，电子烟的使用与香烟依赖的降低有关，而总尼古丁暴露量没有显著增加。
开始使用电子烟同时继续吸烟可能会增加尼古丁依赖。在这项旨在帮助吸烟者减少香烟摄入量的随机试验中，我们发现电子烟的使用与香烟依赖的降低以及电子烟依赖的增加（仅在尼古丁浓度最高的条件下）有关，而总尼古丁依赖或尼古丁暴露量没有长期增加。
