METHODS: We conducted a prospective longitudinal study of Catalan nursing students between 2015-2016 and 2018-2019. We examined transitions in tobacco use patterns between baseline and follow-up among smokers from: 1) daily to non-daily smoking, 2) non-daily to daily smoking, 3) cigarette-only use to poly-tobacco use, 4) poly-tobacco use to cigarette-only use, 5) between products, 6) reducing consumption by ≥5 cigarettes per day (CPD); and 7) quitting smoking. We applied a Generalized Linear Model with a log link (Poisson regression) and robust variance to identify predictors of reducing cigarette consumption by ≥5 CPD and quitting smoking, obtaining both crude and adjusted (APR) prevalence ratios and their 95% confidence intervals (CIs).
RESULTS: Among daily smokers at baseline, 12.1% transitioned to non-daily smoking at follow-up, while 36.2% of non-daily smokers shifted to daily smoking. Among cigarette-only users, 14.2% transitioned to poly-tobacco use, while 48.4% of poly-tobacco users switched to exclusive cigarette use. Among all smokers (daily and non-daily smokers), 60.8% reduced their cigarette consumption by ≥5 CPD and 28.3% quit smoking. Being a non-daily smoker (APR=0.33; 95% CI 0.19-0.55) and having lower nicotine dependence (APR=0.78; 95% CI 0.64-0.96) were inversely associated with reducing cigarette consumption, while being a non-daily smoker (APR=1.19; 95% CI: 1.08-1.31) was directly associated with quitting smoking.
CONCLUSIONS: Nursing students who smoked experienced diverse transitions in tobacco use patterns over time. Evidence-based tobacco use preventive and cessation interventions are needed to tackle tobacco use among future nurses.
方法:我们在2015-2016年至2018-2019年期间对加泰罗尼亚护理专业学生进行了一项前瞻性纵向研究。我们检查了吸烟者在基线和随访之间烟草使用模式的转变,从:1)每天吸烟到非每天吸烟,2)非每日至每日吸烟,3)仅使用香烟来使用聚烟草,4)聚烟使用到仅香烟使用,5)产品之间,6)每天减少≥5支香烟(CPD);和7)戒烟。我们应用了具有对数链接(泊松回归)和鲁棒方差的广义线性模型,以确定减少香烟消费≥5CPD和戒烟的预测因素,获得粗患病率和调整后(APR)患病率及其95%置信区间(CI)。
结果:在基线时每日吸烟者中,12.1%在随访时过渡到非每日吸烟,而36.2%的非每日吸烟者转向每日吸烟。在仅吸烟的用户中,14.2%过渡到聚烟使用,而48.4%的聚烟使用者转而独家使用香烟。在所有吸烟者(每日和非每日吸烟者)中,60.8%的人减少了≥5CPD的香烟消费,28.3%的人戒烟。作为非每日吸烟者(APR=0.33;95%CI0.19-0.55)和较低的尼古丁依赖性(APR=0.78;95%CI0.64-0.96)与减少香烟消费呈负相关,非每日吸烟者(APR=1.19;95%CI:1.08-1.31)与戒烟直接相关。
结论:随着时间的推移,吸烟的护理专业学生经历了不同的烟草使用模式转变。需要基于证据的烟草使用预防和戒烟干预措施,以解决未来护士的烟草使用问题。