Rutgers Center for Tobacco Studies, New Brunswick, NJ, USA.
Department of Biostatistics and Epidemiology, Rutgers School of Public Health, Piscataway, NJ, USA.
Nicotine Tob Res. 2023 Jul 28;25(Suppl_1):S94-S101. doi: 10.1093/ntr/ntad073.
Improved understanding of health conditions associated with premium cigar smoking can inform efforts to reduce cigar use. This paper extends findings commissioned for the National Academies of Science, Engineering, and Medicine report on premium cigars.
We pooled 2010-2019 National Survey on Drug Use and Health data to evaluate cross-sectional associations between premium cigar smoking and mental health and substance use conditions among U.S. adults. A series of logistic regression models adjusted for age, sex, race and ethnicity, cigarette smoking, and alcohol consumption compared odds of each condition associated with past-month premium cigar smoking relative to past-month nonpremium cigar smoking, never tobacco use, and current established cigarette smoking.
Premium cigar smoking was associated with lower adjusted odds of past month serious psychological distress, past year major depressive episode, and cannabis and illicit drug dependence relative to nonpremium cigar and cigarette smoking; however, higher odds of alcohol and cannabis dependence were observed relative to never tobacco use, and lower odds of alcohol dependence were observed relative to current cigarette smoking but not current nonpremium cigar smoking.
We observed considerable variation in both magnitude and direction of associations between premium cigar smoking and mental health and substance use indicators depending on the condition and reference group to which premium cigar smoking was compared.
Premium cigar smoking frequently cooccurs with cigarette smoking and alcohol consumption, thus potential health correlates must be considered in appropriate context. We observed considerable variation in direction and magnitude of association depending on the health condition and reference population, as well as potential for reverse causality and residual confounding in this cross-sectional analysis. As the tobacco landscape continues to evolve, rigorous scientific studies that incorporate clear differentiation of cigar type, measures of cumulative use, and temporal data collection are necessary to fully evaluate the health effects of premium cigar smoking and effectively inform Food and Drug Administration regulation.
更好地了解与优质雪茄吸烟相关的健康状况，可以为减少雪茄使用量提供依据。本文扩展了为美国国家科学院、工程院和医学院关于优质雪茄的报告委托进行的研究结果。
我们汇集了 2010 年至 2019 年全国毒品使用和健康调查的数据，评估了美国成年人中优质雪茄吸烟与心理健康和物质使用状况之间的横断面关联。一系列逻辑回归模型调整了年龄、性别、种族和民族、吸烟和饮酒，比较了每种情况与过去一个月优质雪茄吸烟相对于过去一个月非优质雪茄吸烟、从未吸烟和当前已建立的吸烟的关联的优势比。
与非优质雪茄和香烟吸烟相比，优质雪茄吸烟与过去一个月严重心理困扰、过去一年重性抑郁发作以及大麻和非法药物依赖的调整后优势比降低；然而，与从未吸烟相比，酒精和大麻依赖的优势比更高，与当前香烟吸烟相比，酒精依赖的优势比降低，但与当前非优质雪茄吸烟相比没有降低。
我们观察到，优质雪茄吸烟与心理健康和物质使用指标之间的关联的幅度和方向存在相当大的差异，这取决于与优质雪茄吸烟进行比较的状况和参考群体。在这种横断面分析中，我们观察到关联的方向和幅度取决于健康状况和参考人群，以及潜在的反向因果关系和残余混杂因素，存在相当大的差异。随着烟草状况的不断发展，必须在适当的背景下考虑优质雪茄吸烟的潜在健康相关性，因此，需要进行严格的科学研究，明确区分雪茄类型、累积使用量和时间数据收集，以充分评估优质雪茄吸烟的健康影响，并有效地为食品和药物管理局的监管提供信息。
