Tanner NT, et al. Chest 2020.
BACKGROUND: Over decades, there have been several alterations to cigarettes, including the addition of filters and flavoring. Despite this, lung cancer remains the leading cause of cancer-related death in the US. We aimed to examine the association of type of cigarette on nicotine dependence in the setting of lung cancer screening.
METHODS: This is a secondary analysis of the American College of Radiology Imaging Network arm of the National Lung Screening Trial. Tobacco dependence was evaluated using the Fagerstrӧm Test for Nicotine Dependence, the Heaviness of Smoking Index, and time to first cigarette. Clinical outcomes including nicotine dependence and tobacco abstinence were assessed with descriptive statistics and χ2 tests, stratified by cigarette tar level, flavor, and filter. Logistic regression was used to study the influence of variables on smoking abstinence.
RESULTS: Over one third of individuals presenting for lung cancer screening are highly addicted to nicotine and smoke within 5 minutes of waking up. Smokers of unfiltered cigarettes were more nicotine dependent compared to filtered cigarette smokers (OR 1.32, p<0.01). While smokers of light/ultralight cigarettes had lower dependence (OR 0.76, p<0.0001), there was no difference in smoking abstinence when compared to regular cigarette smokers. There was no difference in outcomes when comparing smokers of mentholated versus unflavored cigarettes.
CONCLUSIONS: In a screening population, the type of cigarette smoked is associated with different levels of dependence. Eliciting type of cigarette and time to first cigarette has the potential to allow for tailored tobacco treatment interventions within this context.