Quitting cigarettes completely or switching to smokeless tobacco: do US data replicate the Swedish results?
Quitting cigarettes completely or switching to smokeless tobacco: do US data replicate the Swedish results?
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DOI：
10.1136/tc.2008.028209
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发表时间：
2009-04-01
期刊：
影响因子：
5.2
通讯作者：
Galanti, M. R.
中科院分区：
文献类型：
--
作者：
Zhu, S-H;Wang, J. B.;Galanti, M. R.
背景：瑞典男性吸烟者比女性吸烟者更有可能改用无烟烟草（鼻烟），并且男性戒烟率高于女性。这些结果引发了关于推广无烟烟草以减少危害的国际辩论。这项研究检验了美国是否出现了类似的结果，美国是长期广泛使用无烟烟草的少数西方国家之一。方法：美国数据来源：2002 年当前人口调查烟草使用补充中的全国样本，并于 2003 年进行了 1 年随访。分析包括该纵向样本中的成年自答者 (n = 15 056)。计算了 1 年期间的人口加权戒烟率和转用无烟烟草的比率。结果：在美国男性中，很少有当前吸烟者转用无烟烟草（12 个月内为 0.3%）。很少有戒烟者转向无烟烟草（1.7%）。在当前烟草使用者中（< 4%），在卷烟和无烟烟草之间转换的情况很少见，但从无烟烟草转向吸烟的情况更为常见。男性戒掉无烟烟草的比例是戒烟率的三倍（38.8% vs 11.6%，p < 0.001）。总体而言，尽管男性使用无烟烟草的可能性要大得多，但美国男性在戒烟方面并不比女性有优势（11.7% vs 12.4%，p = 0.65）。结论：瑞典的结果并未在美国复制。尽管瑞典更多地使用无烟烟草，但美国男性和女性吸烟者的戒烟率似乎都高于瑞典吸烟者。在正在进行烟草控制计划的国家推广无烟烟草以减少危害可能不会对戒烟产生任何积极的人口影响。
Background: Swedish male smokers are more likely than female smokers to switch to smokeless tobacco (snus) and males' smoking cessation rate is higher than that of females. These results have fuelled international debate over promoting smokeless tobacco for harm reduction. This study examines whether similar results emerge in the United States, one of few other western countries where smokeless tobacco has long been widely available.Methods: US data source: national sample in Tobacco Use Supplement to Current Population Survey, 2002, with 1-year follow-up in 2003. Analyses included adult self-respondents in this longitudinal sample (n = 15 056). Population-weighted rates of quitting smoking and switching to smokeless tobacco were computed for the 1-year period.Results: Among US men, few current smokers switched to smokeless tobacco (0.3% in 12 months). Few former smokers turned to smokeless tobacco (1.7%). Switching between cigarettes and smokeless tobacco, infrequent among current tobacco users (< 4%), was more often from smokeless to smoking. Men quit smokeless tobacco at three times the rate of quitting cigarettes (38.8% vs 11.6%, p < 0.001). Overall, US men have no advantage over women in quitting smoking (11.7% vs 12.4%, p = 0.65), even though men are far likelier to use smokeless tobacco.Conclusion: The Swedish results are not replicated in the United States. Both male and female US smokers appear to have higher quit rates for smoking than have their Swedish counterparts, despite greater use of smokeless tobacco in Sweden. Promoting smokeless tobacco for harm reduction in countries with ongoing tobacco control programmes may not result in any positive population effect on smoking cessation.