Department of Health Promotion and Behavioral Sciences, University of Texas Health Science Center, 7000 Fannin St.Houston, TX77030USA.
Center for Tobacco Research & Intervention, University of Wisconsin, 1930 Monroe Street, Suite 200Madison, WI53711USA.
Drug Alcohol Depend. 2023 Sep 1;250:110871. doi: 10.1016/j.drugalcdep.2023.110871. Epub 2023 Jun 22.
Prior studies examining the impact of e-cigarette use, dependence, cessation motivation/goals, and environmental restriction on smoking cessation were based on cross-sectional or shorter-term longitudinal data with binary outcomes. There is also a critical knowledge gap in corresponding impact on vaping cessation. This study aims to fill in these gaps by investigating these factors' effects on speed of progression to smoking and vaping cessation.
This study conducted secondary analysis of data from 13 waves of assessment of adult cigarette users in Wisconsin from October 2015 through July 2019. Cox regression was employed to examine baseline predictors' effects on speed of progression to smoking cessation (past-month abstinence) among 405 exclusive combustible cigarette users and dual users of combustible and electronic cigarettes, as well as progression to vaping cession among 178 dual users.
Dual use of e-cigarettes with cigarettes, lower primary dependence motives of smoking, higher secondary dependence motives of smoking, higher motivation to quit smoking, more ambitious future goals to quit smoking, and more restrictive environment for smoking all contributed to quicker progression to smoking cessation. Dual users with higher secondary dependence motives of smoking or with lower primary dependence motives of vaping progressed faster to vaping cessation.
The findings support that nicotine dependence is product-specific with two distinct constructs: the primary dependence motives are associated with more difficulty to quit, whereas the secondary dependence motives have the opposite effect. Dual users with strong instrumental reasons for smoking may not find e-cigarettes as an effective substitute for cigarettes.
先前研究电子烟使用、依赖、戒烟动机/目标和环境限制对戒烟的影响，都是基于横断面或更短期的纵向数据，且以二分类结局为结果。对于电子烟戒烟的相应影响，也存在一个重要的知识空白。本研究旨在通过调查这些因素对吸烟和电子烟戒烟速度的影响来填补这些空白。
本研究对 2015 年 10 月至 2019 年 7 月期间威斯康星州成年香烟使用者 13 次评估的数据进行了二次分析。Cox 回归用于检验基线预测因子对 405 名仅使用可燃香烟的使用者和可燃香烟与电子烟双使用者的戒烟速度（过去一个月的 abstinence）的影响，以及对 178 名电子烟双使用者的戒烟速度的影响。
电子烟与可燃香烟的双重使用、较低的吸烟原发性依赖动机、较高的吸烟继发性依赖动机、较高的戒烟动机、更具野心的未来戒烟目标以及更严格的吸烟环境，都有助于更快地戒烟。吸烟和电子烟双重使用者的继发性依赖动机较高或原发性依赖动机较低，戒烟速度更快。
研究结果支持尼古丁依赖是具有两种不同结构的产品特异性：原发性依赖动机与戒烟更困难有关，而继发性依赖动机则有相反的效果。有强烈吸烟工具性动机的双重使用者可能不会发现电子烟是香烟的有效替代品。
