The prevalence, predictors and associated health outcomes of high nicotine dependence using three measures among US smokers

被引:50
作者
Schnoll, Robert A. [1 ,2 ]
Goren, Amir [3 ]
Annunziata, Kathy [3 ]
Suaya, Jose A. [4 ]
机构
[1] Univ Penn, Dept Psychiat, Philadelphia, PA 19104 USA
[2] Univ Penn, Abramson Canc Ctr, Philadelphia, PA 19104 USA
[3] Kantar Hlth, Hlth Sci Practice, New York, NY USA
[4] GlaxoSmithKline, Vaccines USA, Philadelphia, PA USA
关键词
Fagerstrom; health-care use; Heaviness of Smoking Index; nicotine dependence; productivity; sensitivity and specificity; time to first cigarette; QUALITY-OF-LIFE; SMOKING-CESSATION; WORK PRODUCTIVITY; FAGERSTROM TEST; 1ST CIGARETTE; TOBACCO DEPENDENCE; MENTAL-DISORDERS; RISK-FACTORS; TRIAL; SCALE;
D O I
10.1111/add.12285
中图分类号
R194 [卫生标准、卫生检查、医药管理];
学科分类号
摘要
AimsUsing the Fagerstrom Test of Nicotine Dependence (FTND), the Heaviness of Smoking Index (HSI) and the time-to-first-cigarette (TTFC), this study estimated prevalence, evaluated optimal scale cut-offs, identified predictors and assessed potential impact on health, productivity and health-care use of high nicotine dependence among US smokers. Design, setting and participantsThis cross-sectional study used 2011 National Health and Wellness Survey data (n=50000). MeasurementsNicotine dependence, demographic data, measures of health, productivity and health-care use and health attitudes were assessed. FindingsThe prevalence of high nicotine dependence ranged from 23% (TTFC<5 minutes) to 63.6% (TTFC<30 minutes). Based on diagnostic accuracy, the cut-offs for high nicotine dependence using HSI and TTFC varied according to FTND cut-off: if FTND>4, then HSI>3 and TTFC<30 minutes represented optimal cut-offs; if FTND>5, HSI>4 and TTFC<5 minutes represented optimal cut-offs. Across all measures, high nicotine dependence was related significantly to being male, single, age 45-64 years and Caucasian; lower education; lack of health insurance; under/unemployment; comorbid respiratory or cardiovascular disease, diabetes or psychiatric illness; and lower rates of exercise and concern for weight control. Controlling for demographic variables and comorbid physical and psychiatric illness, high nicotine dependence, measured by FTND, HSI or TTFC, was associated significantly with reduced mental and physical quality of life, reduced work-place productivity and more health-care use. ConclusionsHigh nicotine dependence is associated with lower quality of life, lower work productivity and higher health-care use. The Heaviness of Smoking Index and the time-to-first-cigarette can provide useful screening measures of nicotine dependence in clinical and research settings.
引用
收藏
页码:1989 / 2000
页数:12
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