Odani Satomi, Tsuno Kanami, Agaku Israel T, Tabuchi Takahiro
Cancer Control Center, Osaka International Cancer Institute, Osaka, Japan
School of Health Innovation, Kanagawa University of Human Services, Kawasaki, Japan.
Tob Control. 2023 Feb 27. doi: 10.1136/tc-2022-057613.
Heated tobacco products (HTPs) are often marketed as a safer alternative to help cigarette smokers quit. We investigated the link between HTP use and smoking cessation and relapse.
7044 adults (≥20 years old) with at least two observations over three waves (2019-2021) of a longitudinal, nationwide, internet-based survey were classified into current (past 30-day), former and never cigarette smokers. ≥1 month and ≥6 months smoking cessation and smoking relapse at 1-year follow-up were assessed in relation to current HTP use at baseline. Generalised estimating equation models were weighted to account for population differences between HTP users and non-users. Adjusted prevalence ratios (APRs) were computed within population subgroups.
At baseline, 17.2%, 9.1% and 6.1% of the respondents were current cigarette smokers, HTP users and dual users, respectively. Among current established smokers (having smoked regularly, n=1910), HTP use was significantly associated with a decreased likelihood of ≥1 month cessation within those who reported having used evidence-based cessation measures (APR=0.61), smoking 20+ cigarettes per day (APR=0.62), high school education or less (APR=0.73) and fair/poor health (APR=0.59). Negative associations were also seen for ≥6 months cessation among those aged 20-29 years (APR=0.56) and full-time workers (APR=0.56). Among former smokers (n=2906), HTP use was associated with smoking relapse within those who last smoked >1 year ago (APR=1.54), among women (APR=1.61), those aged 20-29 years (APR=2.09), those reporting high school education or less (APR=2.36), those who were unemployed/retired (AOR=3.31) and never/non-current alcohol users (APR=2.10).
HTP use did not help smokers quit or prevent former smokers from relapsing. HTPs should not be recommended as a cessation aid.
加热烟草制品（HTP）常被作为一种更安全的替代品进行营销，以帮助吸烟者戒烟。我们调查了使用HTP与戒烟及复吸之间的联系。
在一项基于互联网的全国性纵向调查的三波调查（2019 - 2021年）中，对7044名成年人（≥20岁）进行了至少两次观察，这些成年人被分为当前吸烟者（过去30天内）、曾经吸烟者和从不吸烟者。在1年随访时，评估了与基线时当前使用HTP相关的≥1个月和≥6个月的戒烟情况以及吸烟复吸情况。采用广义估计方程模型进行加权，以考虑HTP使用者和非使用者之间的人群差异。在人群亚组内计算调整后的患病率比（APR）。
在基线时，分别有17.2%、9.1%和6.1%的受访者为当前吸烟者、HTP使用者和双重使用者。在当前已确立的吸烟者（经常吸烟，n = 1910）中，使用HTP与报告使用循证戒烟措施者（APR = 0.61）、每天吸烟20支及以上者（APR = 0.62）、高中及以下学历者（APR = 0.73）以及健康状况一般/较差者（APR = 0.59）中≥1个月戒烟可能性降低显著相关。在20 - 29岁者（APR = 0.56）和全职工作者（APR = 0.56）中，≥6个月戒烟也呈现负相关。在曾经吸烟者（n = 2906）中，使用HTP与最后一次吸烟超过1年前者（APR = 1.54）、女性（APR = 1.61）、20 - 29岁者（APR = 2.09）、报告高中及以下学历者（APR = 2.36）、失业/退休者（AOR = 3.31）以及从不/当前不饮酒者（APR = 2.10）的吸烟复吸相关。
使用HTP无助于吸烟者戒烟或防止曾经吸烟者复吸。不应推荐HTP作为戒烟辅助工具。
