美国国立卫生院研究表明电子烟成瘾性显著低于香烟

这两天又读到一篇国外对电子烟的研究,大概说了两个结论。一是电子烟成瘾性显著低于香烟,二是研究者认为,电子烟作为减害产品有一定的成瘾性长期看是好事。这个研究结果让我非常兴奋,因为如果该研究被认可,就意味着电子烟理论上有成为戒烟工具的可能。下面是具体的研究内容,有些过于学术了,我也看不懂,我尽量说的简单和容易点。

2020年3月20日,美国国家医学图书馆和国立卫生院在官网上发布了一篇电子烟成瘾性的研究。该研究的标题为《美国成年人对电子烟和卷烟的依赖性横向对比 》,研究以美国成年人代表为样本,分析比较了13311名电子烟用户和传统烟民,在当前、以前和双重使用电子烟和香烟后心理计量学的依赖性。

研究人员发现,与媒体报道相反,用户对电子烟的依赖性明显低于对常规香烟的依赖性。“毫无疑问,电子烟会让人上瘾,但与传统香烟相比却不一样。我们对比了电子烟和香烟双重用户,他们对电子烟的依赖性显著低于香烟(1.58 [SE = 0.05]对2.76 [0.04]),p < 0.0001)。不仅如此,电子烟用户和吸烟者的单独分组研究同样表明电子烟的成瘾性低于香烟(1.95 [0.05] vs. 2.52 [0.02],p <0.0001)。”

研究显示,很少有电子烟使用者高度依赖电子烟,但是大多数吸烟者却高度依赖香烟。有趣的是,电子烟用户中依赖程度最高的反而是为了戒烟停止吸烟而转用电子烟的人,而那些没有吸烟史,只用电子烟的人,依赖度最低。研究人员认为,这与吸烟者通过将其依赖关系转移和过渡到电子烟的想法是一致的。可能正是基于这样的原因和事实,他们停止吸烟,并完全过渡到电子烟中,成为那批最有可能经常使用电子香烟的人群。但无论烟瘾大小,也无论是否仍然使用电子烟,研究者发现在各种情况的分组对比下,结果具有一致性——对电子烟的依赖性都大大低于对香烟的依赖性。这表明谁从吸烟转到电子香烟可能会减少他们对尼古丁的依赖,以及健康风险。

研究人员最终得出一个建议性的结论:现代医学已经指出,香烟的危害并不是尼古丁依赖,而是暴露于香烟烟气中的其他有毒物质引起的。事实上,减少危害的倡导者们认为,从减少危害的角度来讲,如果电子烟未来能成功取代香烟进而降低使用者的风险, 那么电子烟在应该一定程度上具有依赖性, 一些减害产品甚至因为没能让用户有依赖导致不好普及反而受到批判。所以,权衡电子烟减少对身体的预期伤害时,我们认为一些持续的依赖性可能是有利的,甚至是必要的。

以上就是研究的过程和大致内容了。严谨的研究一定要查阅诸多资料,下面是该研究参考过的文献,共36篇。我决定都放出来,让国内那些还没搞清楚怎么回事就信口开河抹黑电子烟的媒体看看,做研究、说结论最起码应该是怎样认真的态度和方式。

  • 1Wang T. W., Asman K., Gentzke A. S., Cullen K. A., Holder‐Hayes E., Reyes‐Guzman C., et al. Tobacco product use among adults ‐ United States, 2017. MMWR Morb Mortal Wkly Rep 2018; 67: 1225– 1232.Crossref PubMed Web of Science®Google Scholar
  • 2 National Academies of Sciences Engineering and Medicine Public Health Consequences of E‐Cigarettes. Washington, DC: The National Academies Press; 2018.Google Scholar
  • 3Mcneill A., Brose L. S., Calder R., Bauld L., Robson D. A report commissioned by Public Health England. London: Public Health England; 2018.Google Scholar
  • 4Avdalovic M. V., Murin S. POINT: does the risk of electronic cigarettes exceed potential benefits? Yes, Chest 2015; 148: 580– 582.Crossref PubMed Web of Science®Google Scholar
  • 5Etter J. F., Eissenberg T. Dependence levels in users of electronic cigarettes, nicotine gums and tobacco cigarettes. Drug Alcohol Depend 2015; 147: 68– 75.Crossref PubMed Web of Science®Google Scholar
  • 6Farsalinos K. E., Romagna G., Tsiapras D., Kyrzopoulos S., Voudris V. Evaluating nicotine levels selection and patterns of electronic cigarette use in a group of “vapers” who had achieved complete substitution of smoking. Subst Abuse: Res Treatment 2013; 7: 139– 146.Crossref PubMed Google Scholar
  • 7Jankowski M., Krzystanek M., Zejda J. E., Majek P., Lubanski J., Lawson J. A., et al. E‐cigarettes are more addictive than traditional cigarettes‐a study in highly educated young people. Int J Environ Res Public Health 2019; 16.Crossref Web of Science®Google Scholar
  • 8Morean M., Krishnan‐Sarin S., O’malley S. S. Comparing cigarette and e‐cigarette dependence and predicting frequency of smoking and e‐cigarette use in dual‐users of cigarettes and e‐cigarettes. Addict Behav 2018; 87: 92– 96.Crossref PubMed Web of Science®Google Scholar
  • 9Smith S. S., Piper M. E., Bolt D. M., Fiore M. C., Wetter D. W., Cinciripini P. M., et al. Development of the brief Wisconsin inventory of smoking dependence motives. Nicotine Tob Res 2010; 12: 489– 499.Crossref PubMed Web of Science®Google Scholar
  • 10Shiffman S., Waters A., Hickcox M. The nicotine dependence syndrome scale: a multidimensional measure of nicotine dependence. Nicotine Tob Res 2004; 6: 327– 348.Crossref CAS PubMed Web of Science®Google Scholar
  • 11Sterling K. L., Mermelstein R., Turner L., Diviak K., Flay B., Shiffman S. Examining the psychometric properties and predictive validity of a youth‐specific version of the nicotine dependence syndrome scale (NDSS) among teens with varying levels of smoking. Addict Behav 2009; 34: 616– 619.Crossref PubMed Web of Science®Google Scholar
  • 12Piper M. E., Baker T. B., Benowitz N. L., Smith S. S., Jorenby D. E. E‐cigarette dependence measures in dual users: reliability and relations with dependence criteria and E‐cigarette cessation. Nicotine Tob Res 2019. https://academic.oup.com/ntr/advance-article-abstract/doi/10.1093/ntr/ntz040/5381490Crossref Google Scholar
  • 13Piper M. E., Bolt D. M., Kim S. Y., Japuntich S. J., Smith S. S., Niederdeppe J., et al. Refining the tobacco dependence phenotype using the Wisconsin inventory of smoking dependence motives. J Abnorm Psychol 2008; 117: 747– 761.Crossref PubMed Web of Science®Google Scholar
  • 14Piper M. E., Mccarthy D. E., Bolt D. M., Smith S. S., Lerman C., Benowitz N., et al. Assessing dimensions of nicotine dependence: an evaluation of the nicotine dependence syndrome scale (NDSS) and the Wisconsin inventory of smoking dependence motives (WISDM). Nicotine Tob Res 2008; 10: 1009– 1020.Crossref CAS PubMed Web of Science®Google Scholar
  • 15Adkison S. E., Rees V. W., Bansal‐Travers M., Hatsukami D. K., O’connor R. J. Psychometric characteristics of the brief Wisconsin inventory of smoking dependence motives among a nonclinical sample of smokers. Nicotine Tob Res 2016; 18: 470– 476.Crossref CAS PubMed Web of Science®Google Scholar
  • 16Japuntich S. J., Piper M. E., Schlam T. R., Bolt D. M., Baker T. B. Do smokers know what we’re talking about? The construct validity of nicotine dependence questionnaire measures. Psychol Assess 2009; 21: 595– 607.Crossref PubMed Web of Science®Google Scholar
  • 17Piasecki T. M., Piper M. E., Baker T. B. Refining the tobacco dependence phenotype using the Wisconsin inventory of smoking dependence motives: II. Evidence from a laboratory self‐administration assay. J Abnorm Psychol 2010; 119: 513– 523.Crossref PubMed Web of Science®Google Scholar
  • 18 American Psychiatric Association., American Psychiatric Association Dsm‐5 Task Force. Diagnostic and statistical manual of mental disorders: DSM‐5. Washington, D.C.: American Psychiatric Association; 2013.Crossref Google Scholar
  • 19Baker T. B., Breslau N., Covey L., Shiffman S. DSM criteria for tobacco use disorder and tobacco withdrawal: a critique and proposed revisions for DSM‐5. Addiction 2012; 107: 263– 275.Wiley Online Library PubMed Web of Science®Google Scholar
  • 20Pomerleau C. S., Carton S. M., Lutzke M. L., Flessland K. A., Pomerleau O. F. Reliability of the Fagerstrom tolerance questionnaire and the Fagerstrom test for nicotine dependence. Addict Behav 1994; 19: 33– 39.Crossref CAS PubMed Web of Science®Google Scholar
  • 21Strong D. R., Pearson J., Ehlke S., Kirchner T., Abrams D., Taylor K., et al. Indicators of dependence for different types of tobacco product users: descriptive findings from wave 1 (2013‐2014) of the population assessment of tobacco and health (PATH) study. Drug Alcohol Depend 2017; 178: 257– 266.Crossref PubMed Web of Science®Google Scholar
  • 22Embretson S. E., Reise S. P. Item response theory for psychologists. Mahwah, N.J.: Lawrence Erlbaum Associates; 2000.Google Scholar
  • 23 Truth Initiative. E‐cigarettes: Facts, stats and regulations. 2019. Available at https://truthinitiative.org/research‐resources/emerging‐tobacco‐products/e‐cigarettes‐facts‐stats‐and‐regulations.Google Scholar
  • 24Manzoli L., Flacco M. E., Ferrante M., La Vecchia C., Siliquini R., Ricciardi W., et al. Cohort study of electronic cigarette use: effectiveness and safety at 24 months. Tob Control 2017; 26: 284– 292.Crossref PubMed Web of Science®Google Scholar
  • 25Hyland A., Ambrose B. K., Conway K. P., Borek N., Lambert E., Carusi C., et al. Design and methods of the population assessment of tobacco and health (PATH) study. Tob Control 2017; 26: 371– 378.Crossref PubMed Web of Science®Google Scholar
  • 26 United States Department of Health and Human Services; National Institutes of Health; National Institute on Drug Abuse; Food and Drug Administration; Center for Tobacco Products. Population Assessment of Tobacco and Health (PATH) Study [United States] Public‐Use Files. Ann Arbor, MI: Inter‐university Consortium for Political and Social Research [distributor], 2018‐09‐28. https://doi.org/10.3886/ICPSR36498.v8, 2018.Google Scholar
  • 27 United States Department of Health and Human Services, National Institutes of Health, National Institute on Drug Abuse, Food and Drug Administration, Center for Tobacco Products. Population Assessment of Tobacco and Health (PATH) Study [United States] Public‐Use Files: Inter‐university Consortium for Political and Social Research [distributor]; 2018.Google Scholar
  • 28Breslau N., Johnson E. O., Hiripi E., Kessler R. Nicotine dependence in the United States: prevalence, trends, and smoking persistence. Arch Gen Psychiatry 2001; 58: 810– 816.Crossref CAS PubMed Web of Science®Google Scholar
  • 29Liu G., Wasserman E., Kong L., Foulds J. A comparison of nicotine dependence among exclusive E‐cigarette and cigarette users in the PATH study. Prev Med 2017; 104: 86– 91.Crossref PubMed Web of Science®Google Scholar
  • 30Biener L., Hargraves J. L. A longitudinal study of electronic cigarette use among a population‐based sample of adult smokers: association with smoking cessation and motivation to quit. Nicotine Tob Res 2015; 17: 127– 133.Crossref PubMed Web of Science®Google Scholar
  • 31Levy D. T., Yuan Z., Luo Y., Abrams D. B. The relationship of E‐cigarette use to cigarette quit attempts and cessation: insights from a large, nationally representative U.S. survey. Nicotine Tob Res 2018; 20: 931– 939.Crossref PubMed Web of Science®Google Scholar
  • 32Gottlieb S., Zeller M. A nicotine‐focused framework for public health. N Engl J Med 2017; 377: 1111– 1114.Crossref PubMed Web of Science®Google Scholar
  • 33 Royal College of Physicians. Nicotine without smoke: Tobacco harm reduction. London: RCP, 2016, 2016.Google Scholar
  • 34Abrams D. B., Glasser A. M., Pearson J. L., Villanti A. C., Collins L. K., Niaura R. S. Harm minimization and tobacco control: reframing societal views of nicotine use to rapidly save lives. Annu Rev Public Health 2018; 39: 193– 213.Crossref PubMed Web of Science®Google Scholar
  • 35Britton J., Arnott D., Mcneill A., Hopkinson N. Tobacco advisory Group of the Royal College of P. nicotine without smoke‐putting electronic cigarettes in context. BMJ 2016; 353: i1745.Crossref PubMed Web of Science®Google Scholar
  • 36 Food and Drug Administration. FDA Briefing Document. September 13–14, 2018 Meeting of the Tobacco Products Scientific Advisory Committee (TPSAC). Modified Risk Tobacco Product Applications (MRPTAs) MR0000068‐MR0000073 RJ Reynolds Tobacco Company. https://www.fda.gov/downloads/AdvisoryCommittees/CommitteesMeetingMaterials/TobaccoProductsScientificAdvisoryCommittee/UCM620064.pdf. Accessed June 26, 2019.Google Scholar

发表评论