Do nicotine dependence influencing and non-influencing behaviors have an association with high nicotine dependence in smokers?

INTRODUCTION: Nicotine dependence (ND) is a maladaptive pattern of tobacco smoking with withdrawal symptoms similar to other drug addictive disorders. It is very common in clinical practice that smokers always have different degrees of nicotine dependence with the same amount of tobacco consumption. Behaviors may influence daily cigarette consumption or smoking status. Hence it is critical to ascertain the association between concurrent behaviors and high nicotine dependence among smokers. METHODS: A total of 343 patients who attended a clinic for smoking cessation were recruited, and the information on concurrent behaviors were recorded. Factors associated and not associated with nicotine dependence were recorded. Nicotine dependence was determined by Fagerström test for nicotine dependence (FTND). RESULTS: High ND patients (FTND >5) showed significant behaviors distribution compared with mild and moderate ND patients (FTND ≤5). There is no single behavior that was significantly different between high ND and mild and moderate ND smokers. However, the combined effects of nicotine dependence influencing behaviors of caffeine drinking and mental activities after dinner have an association with high ND (OR=1.939; 95% CI: 1.154–3.258, p=0.012). In addition, the combined effects of inadequate sleep time (<8 hours), caffeine drinking and mental activities after dinner significantly distinguished patients of high ND from those of low ND (OR=2.208; 95% CI: 1.032–4.737, p=0.042). CONCLUSIONS: Interaction effects of mental activities after dinner and caffeine drinking have an association with high nicotine dependence. Sleep of less than 8 hours with behaviors of mental activities after dinner and caffeine drinking have the same effect.