Background

The hardening hypothesis proposes that as smoking rates decline, the remaining smokers will become hardcore and resistant to quitting. This group of highly resistant quitters will potentially require more individualistic approaches to cessation and harm reduction. The harm reduction approach (specifically e-cigarettes) has been proposed as an option to address hardened Australian smokers. We tested the hardening hypothesis by analysing the rates of hardcore smoking in the Australian smoking population between 2010 and 2016.

Methods

Data were drawn from three waves of the National Drug Strategy Household Survey (NDSHS) in 2010, 2013 and 2016. Two different definitions were used to assess hardcore smoking to arrive at an upper and lower rate. Logistic regression models assessed hardcore smoker characteristics for both definitions of hardcore smoking.

Results

The most inclusive definition of hardcore smoking (i.e., a smoker with no plan to quit) showed a significant decline in hardcore smoking between 2010 and 2016 (5.49%–4.85%) In contrast, the prevalence of hardcore smoking using the most stringent definition (i.e., a current daily smoker of at least 15 cigarettes per day, aged 26 years or over, with no intention to quit, a lifetime consumption of at least 100 cigarettes, and no quit attempt in the past 12 months) did not change significantly between 2010 and 2016.

Conclusion

The observed trends in the prevalence of hardcore smokers (i.e., either stable or declining depending on the definition) suggest that the Australian smoking population is not hardening. These results do not support claims that remaining smokers are becoming hardcore.

中文翻译：

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澳大利亚吸烟人口在增加吗？

背景

严格的假设表明，随着吸烟率的下降，其余吸烟者将变得顽固并且难以戒烟。这组高抵抗力戒烟者可能需要更多的个人主义方法来戒烟和减少伤害。已提出减少危害的方法（特别是电子烟）作为解决澳大利亚烟民的一种选择。我们通过分析2010年至2016年间澳大利亚吸烟人口中的顽固性吸烟率来检验强化假设。

方法

数据来自2010年，2013年和2016年的三波国家毒品战略家庭调查（NDSHS）。使用两种不同的定义来评估顽固性吸烟率的高低。逻辑回归模型评估了铁杆吸烟者对铁杆吸烟的两种定义的特征。

结果

铁杆吸烟的最包容性定义（即，无计划戒烟的吸烟者）显示，2010年至2016年之间铁杆吸烟显着下降（5.49％–4.85％）。与此相反，使用最严格的定义，铁杆吸烟的流行率（例如，目前每天吸烟至少每天15支香烟，年龄26岁或以上，无戒烟意愿，终生至少消费100支香烟，并且过去12个月内没有戒烟尝试）在这之间没有明显变化2010年和2016年。

结论

观察到的铁杆吸烟者流行趋势（即，稳定或下降取决于定义）表明澳大利亚的吸烟人口并未增加。这些结果不支持声称剩余吸烟者正变得顽固的说法。