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Abstract：
BACKGROUND: The use of emerging tobacco and nicotine products affects tobacco use behaviors among college students. Thus, we aimed to examine transitions in tobacco use patterns and identify their predictors among smokers in a cohort of nursing students in Catalonia (Spain).
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.
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.
摘要：
背景：新兴烟草和尼古丁产品的使用会影响大学生的烟草使用行为。因此，我们的目的是在加泰罗尼亚(西班牙)的一组护理专业学生中,研究吸烟人群中烟草使用模式的转变,并确定其预测因素.
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。
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。
