| 其他摘要 | Nicotine is a main cause for cigarette addiction. Nicotine can help to establish and maintain tobacco addiction through its complex effects on brain neurochemistry. Long-term use of tobacco leads to physical and psychological dependence and a variety of physical diseases, which seriously harms the public health. Early tobacco policies were mainly external measures for reducing tobacco access. They did not take the standpoint from the smokers and realized that smoking was essentially an addictive behavior. Recent tobacco related policies have gradually focused on the addictive nature of smoking and have announced the control of nicotine content in tobacco products. Moreover, researchers also propose that reducing nicotine is one way to reduce the level of tobacco use. To study the effect of nicotine content in cigarettes on the change of smoking behavior may help to achieve the goal of quitting smoking and reducing smoking. In this study, using ecological instantaneous assessment and questionnaire, the researcher explored the effects of two nicotine content reduction interventions (i.e., immediate reduction and gradual reduction) on decreasing smoking behavior and nicotine dependence, as well as improving mood state, quality of life.In this study, 73 subjects who completed the experiment were smokers in Beijing. All subjects had the intention to quit smoking or to reduce smoking in the near future. They were randomly divided into three groups, two intervention groups including immediate reduction group (n = 26, 25 male) and gradual reduction group (n = 27, 26 male), and one control group without any intervention (n =20, 20 male). The subjects were divided as high dose smoker (>15 cigarette/day) and low dose smoker (< 15 cigarette/day). For intervention, the subjects in the immediate reduction group replaced their cigarettes to the ones contain the nicotine of 0.1 mg/one for 12 weeks; the subjects in the gradual reduction group replaced their cigarette to the ones contain the nicotine of 0.6mg, 0.3mg, and 0.1mg/one (decreasing one level every month) for 12 weeks; the control group received no intervention. The demographic information and smoking habits of subjects were collected before the intervention. The researcher evaluated the subjects’ emotional state (SDS, SAS, POMS), quality of life (WHOQOL-BREF) and nicotine dependence (FTND) at pre-test and post-test. Moreover, the daily data of smoking quantity, mood before and after smoking and craving for cigarettes were recorded by the ecological momentary assessment (EMA) at pre-test (week 1), intervention period (week 2-13), and post-test (week 14). Three-way repeated measurement ANOVA was used for data analysis. The results show that: (1) the change of smoking amount: there was significant difference between three groups. The change of the mean daily smoking amount in the immediate reduction group was significantly smaller than that of the gradual reduction group and the control group, while the mean daily smoking amount change in the gradual reduction group and the control group had no significant difference. It indicated that compared with the gradual reduction group, the immediate reduction group had a better reduction effect. The results showed that the change of smoking quantity in the high dose smoking group was significantly lower than that of the low dose smoking group. (2) the quality of life score was higher after the intervention; anxiety and depression were significantly lower after the intervention; the emotional disorder scores of the high dose smoking group were higher than that of the low dose smoking group no matter which smoking mode was adopted.The nicotine dependence of the high dose smoking group was significantly higher than the low dose smoking group, and the dependence score of the immediate reduction group after intervention was significantly lower than the control group. (3) the craving in the morning and evening before and after smoking decreased with time in the low and high dose smoking groups; in the low dose smoking group, the mood value of morning and evening before and after smoking in the gradual group was significantly higher than that in the immediate group, and there was no significant difference in the high dose smoking group.In summary, nicotine is closely related to smoking addiction. Reducing nicotine content in cigarettes can change smoking behavior.Two interventions (immediate reduction and gradual reduction) have different effects on the change of smoking behavior. After 3 months of intervention, among the different smokers, nicotine content reduction was better for the high dose smoking population. The subjects' emotional state had improved, the level of anxiety and depression had reduced, the level of quality of life had improved, the level of nicotine dependence had reduced, and the craving of high and low dose smoking groups before and after smoking decreased with time. In the low dose smoking group, the emotional value of early and late before and after smoking in the gradual group was significantly higher than that in the immediate group. This study has some scientific research implications. It can not only clarify the effect of reducing nicotine in cigarettes on changing smoking behavior, but also further explore the individual differences of nicotine reduction effects on smoking behavior. It can also provide guidance for intervention programs for reducing smoking addiction in different populations using nicotine reduction as an intervention. |
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