Norwegian National Advisory Unit on Concurrent Substance Abuse and Mental Health Disorders, Innlandet Hospital Trust, Brumunddal, Norway.
Department of Health and Social Science, Inland Norway University of Applied Sciences, Hamarvegen 112, 2406, Elverum, Norway.
Harm Reduct J. 2024 Sep 20;21(1):173. doi: 10.1186/s12954-024-01077-9.
Smoking is negatively related to mental health, but there is a paucity of research on the relationship between the use of smokeless tobacco, such as snus, and mental health outcomes, especially in people with alcohol use disorders (AUD). The aim of the present study was to examine the development of mental distress and quality of life (QoL) among AUD patients in treatment who did or did not use snus.
The study included 128 AUD patients (27% female) from three rehabilitation clinics in Eastern Norway who were interviewed at admission, at 6 weeks, and after 6 months. Patients were asked about their mental health-related problems, alcohol, and substance use, QoL, and physical activity. Information about tobacco use was gathered with the questions "Do you smoke cigarettes?" and "Do you use snus?", with follow-up questions "How often?".
There were 39 current snus users (31%), of which 20 were also current smokers (dual users). Seventy-five patients (59%) were smokers only, and only 14 (11%) patients were abstainers. Those who used snus only had a lower severity of dependence score than the other groups (p < 0.05). The dual use group reported lower QoL than the no tobacco use group. In a regression model adjusted for sex and age, smokers and dual users, but not users of snus, had higher levels of mental distress and poorer QoL compared to nontobacco users (p < 0.05). There were no differences between tobacco groups at follow-ups.
In this study, among AUD patients, snus users reported QoL and mental distress close to that of non-smokers, indicating a lower problem load among snus users compared to smokers.
Previous studies have shown conflicting results regarding the potential harm reduction effect of snus use among patients with AUD who smoke regarding their tobacco use, quality of life and mental health problems. This study suggests that snus use could also be a viable alternative to smoking for patients with addictions.
吸烟与心理健康呈负相关，但关于使用无烟烟草（如鼻烟）与心理健康结果之间的关系的研究甚少，尤其是在患有酒精使用障碍（AUD）的人群中。本研究旨在探讨在接受治疗的 AUD 患者中，使用鼻烟与不使用鼻烟的患者的精神困扰和生活质量（QoL）的发展情况。
该研究纳入了来自挪威东部三家康复诊所的 128 名 AUD 患者（27%为女性），他们在入院时、6 周时和 6 个月时接受了访谈。患者被问及他们的心理健康相关问题、酒精和物质使用情况、QoL 和身体活动情况。使用“你是否吸烟？”和“你是否使用鼻烟？”来收集有关烟草使用的信息，并跟进询问“多久使用一次？”
有 39 名患者（31%）目前使用鼻烟，其中 20 名患者同时也是吸烟者（双重使用者）。75 名患者（59%）仅吸烟，仅有 14 名患者（11%）不吸烟。仅使用鼻烟的患者的依赖严重程度评分低于其他组（p<0.05）。双重使用者报告的 QoL 低于无烟草使用组。在调整性别和年龄的回归模型中，与非烟草使用者相比，吸烟者和双重使用者，但不是鼻烟使用者，其精神困扰和 QoL 水平更高（p<0.05）。在随访中，各组之间不存在差异。
在这项研究中，在 AUD 患者中，鼻烟使用者报告的 QoL 和精神困扰与非吸烟者相近，表明与吸烟者相比，鼻烟使用者的问题负担较低。
先前的研究表明，对于同时吸烟的 AUD 患者，使用鼻烟可能会降低吸烟的潜在危害，减少他们的烟草使用、生活质量和心理健康问题。本研究表明，对于成瘾患者来说，鼻烟的使用也可能是吸烟的可行替代方法。
