Evaluating Cigarette Relighting Behavior: Prevalence, Correlates, Toxicant Exposure, and Implications for Cessation

评估重新点燃香烟的行为：流行率、相关性、有毒物质暴露以及对戒烟的影响

• 批准号: 10570252
• 负责人: Carolyn Heckman
• 金额: $ 63.52万
• 依托单位: RUTGERS BIOMEDICAL AND HEALTH SCIENCES
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-02-15 至 2026-01-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10570252
• 关键词: Abstinence; Address; Adult; Affect; American; Back; Behavior; Behavior Therapy; Behavioral; Carbon Monoxide; Carcinogens; Chronic Bronchitis; Cigarette; Cigarette Smoker; Clinic; Clinical; Compensation; Data; Data Analyses; Dedications; Dependence; Disparity; Dose; Economics; Education; Environment; Epidemiology; Evaluation; Exhalation; Exposure to; Formaldehyde; Foundations; Frequencies; Future; Harm Reduction; Health; Health Benefit; Health Status; High Prevalence; Individual; International Agency for Research on Cancer; Intervention; Knowledge; Lead; Lighting; Malignant neoplasm of lung; Measurement; Measures; Mental Health; Motivation; Nicotine; Nicotine Dependence; Outcome; Participant; Pattern; Pharmacological Treatment; Pharmacotherapy; Pilot Projects; Population; Prevalence; Provider; Public Health; Reporting; Research; Risk; Sampling; Science; Smoke; Smoker; Smoking; Smoking Behavior; Smoking Cessation Intervention; Subgroup; Surveys; Time; Tobacco; Tobacco Dependence; Tobacco Industry; Tobacco Surveillance; Tobacco Use Cessation; Tobacco-Associated Carcinogen; Toxic effect; Toxicant exposure; cigarette smoke; contextual factors; cost; disenfranchised population; experimental group; health disparity; high risk; low socioeconomic status; pharmacologic; population survey; primary outcome; prospective; response; smoking cessation; smoking prevalence; success; tobacco control; tobacco exposure; tobacco toxicant; toxicant; treatment and outcome; treatment comparison; treatment program; treatment strategy

Although smoking prevalence has decreased, more than 34 million Americans continue to smoke. Disenfranchised groups increasingly comprise the remaining smoking population, and cigarette relighters may be some of the most disenfranchised (e.g., low socioeconomic status). Relighting refers to extinguishing, saving, and later relighting unfinished cigarettes. Research suggests this is a prevalent behavior engaged in by 44-73% of smokers, with 17-21% of smokers reporting they relight ‘usually’ or ‘frequently’, thus impacting millions of Americans. Apparent reasons for relighting include cost, perceived benefits for health and cessation, and smoking bans. This behavior may increase harms to smokers such as lung cancer and chronic bronchitis. For example, relighting could contribute to worse cessation and health outcomes if relighters (who tend to be highly nicotine-dependent) have lower motivation toward total abstinence because they believe they are minimizing the amount they smoke. They may also be inadequately treated and advised by clinicians because they appear to be less dependent or smoke fewer numbers of cigarettes per day (CPD) compared to non-relighters, despite a greater number of smoking sessions per day and exposure to toxicants. This could lead to under-dosing of pharmacotherapy. Given that reasons for relighting include the increasing cost of cigarettes, prevalence of relighting may grow in the future (especially during this economic crisis) and may continue to impact disproportionately those with greater existing tobacco-related disparities. More research is needed to address these challenges by investigating who relights and why, and potential effects of relighting on tobacco dependence, cessation, and health. Understanding relighting is critical because: 1) current assessments (i.e., CPD) may underestimate toxicant exposure and nicotine dependence among relighters and 2) if relighting continues to be largely ignored by providers, a high proportion of smokers may be undertreated. Specific aims of this four-year project are to: 1) Establish criteria and reasons for, as well as prevalence, frequency, and correlates of relighting in a national survey; 2) Evaluate potential toxic effects of relighting using topography and toxicant analyses; 3) Investigate the potential impact of relighting by observing tobacco treatment and outcomes of relighters in a state-wide tobacco treatment program. Preliminary studies need to be replicated and extended to be more rigorous, comprehensive, and on a larger scale to address numerous remaining questions that would lay the groundwork for understanding the individual and public health impact of relighting. This study will provide important information about the extent, frequency, contextual factors, and potential dangers of this understudied behavior. The study has implications for both surveillance and treatment such as new measures to screen for relighting clinically and in population surveys as well as potentially informing clinicians in prescribing appropriate-intensity treatments for relighters. Together, data from the proposed specific aims will provide a clearer picture of the extent and impact of cigarette relighting.

尽管吸烟率有所下降，但仍有超过 3400 万美国人继续吸烟。被剥夺权利的群体越来越多地包括剩余的吸烟人口，而重新点燃香烟的人可能是最被剥夺权利的群体之一（例如，社会经济地位较低）。重新点燃是指将未抽完的香烟熄灭、保存并随后重新点燃。研究表明，这是 44-73% 吸烟者普遍存在的行为，其中 17-21% 的吸烟者表示他们“通常”或“经常”重新吸烟，从而影响了数百万美国人。重新点燃的明显原因包括成本、对健康和戒烟的好处以及禁烟令。这种行为可能会增加吸烟者罹患肺癌、慢性支气管炎等危害。例如，如果重新点燃者（往往高度依赖尼古丁）完全戒烟的动机较低，因为他们相信自己正在最大限度地减少吸烟量，那么重新点燃可能会导致更糟糕的戒烟和健康结果。他们也可能没有得到临床医生的充分治疗和建议，因为尽管每天吸烟次数较多且接触有毒物质，但与非重新点燃者相比，他们似乎依赖性较低或每天吸烟数量 (CPD) 较少。这可能导致药物治疗剂量不足。鉴于重新点燃的原因包括卷烟成本的增加，重新点燃的流行率在未来可能会增加（特别是在这场经济危机期间），并且可能继续对那些现有烟草相关差异较大的人产生不成比例的影响。需要进行更多研究来应对这些挑战，调查谁重新吸烟、原因以及重新吸烟对烟草依赖、戒烟和健康的潜在影响。了解重新点燃至关重要，因为：1) 当前的评估（即 CPD）可能低估了重新点燃者的毒物暴露和尼古丁依赖性，2) 如果重新点燃继续被提供者忽视，很大一部分吸烟者可能得不到充分治疗。这个为期四年的项目的具体目标是： 1) 在全国调查中建立重新点燃的标准和原因以及流行率、频率和相关性； 2) 使用地形和毒物分析评估重新照明的潜在毒性影响； 3) 通过观察全州烟草治疗计划中的烟草治疗和重新点燃者的结果，调查重新点燃的潜在影响。初步研究需要进行重复和扩展，以更加严格、全面和更大规模，以解决许多遗留问题，为理解重新照明对个人和公共健康的影响奠定基础。这项研究将提供有关这种未被充分研究的行为的程度、频率、背景因素和潜在危险的重要信息。该研究对监测和治疗都有影响，例如临床和人口调查中筛查重新点燃的新措施，以及可能为临床医生为重新点燃者开出适当强度的治疗处方提供信息。总之，来自拟议具体目标的数据将更清楚地了解重新点燃卷烟的程度和影响。