Initiation, Progression, and Sustained Waterpipe Use: A Nationally Representative Longitudinal Study of U.S. Young Adults.
Initiation, Progression, and Sustained Waterpipe Use: A Nationally Representative Longitudinal Study of U.S. Young Adults.
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DOI：
10.1158/1055-9965.epi-16-0687-t
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发表时间：
2017-05
期刊：
影响因子：
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通讯作者：
Primack BA
中科院分区：
文献类型：
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作者：
Sidani JE;Shensa A;Naidu MR;Yabes JG;Primack BA
尽管有证据表明水烟吸烟有危害和潜在的依赖性，但水烟吸烟（WTS）越来越受欢迎。由于缺乏与WTS启动独立相关的使用模式和因素的纵向、具有全国代表性的数据，干预措施的发展受到阻碍。因此，我们的目标是在一个具有全国代表性的年轻人群体中描述WTS状态之间的关键转变，特别关注与起始相关的独立因素。参与者是从全国概率小组中随机选择的，代表了美国97%的人口。共有1785名18 - 30岁的成年人在2013年和2014年间隔18个月完成了两次基于网络的调查。评估包括对水烟烟雾成分的了解、对水烟的积极和消极态度、规范性信念、使用水烟的意图和水烟行为。我们使用多变量逻辑回归来评估预测因素与随后WTS发生之间的关系。在完全调整的模型中，对与WTS相关的毒物的总体了解与随后的WTS发病无关。同样，消极态度和规范性信念与WTS摄取无关。然而，基线积极态度与WTS开始密切相关（调整优势比[AOR]=1.7, 95% CI= 1.2-2.3）。同样，基线使用WTS的意向与后续起始治疗密切相关（AOR=7.0, 95% CI= 3.5-13.7）。如果针对有明确意图使用WTS并挑战围绕WTS的积极态度的个人，预防工作可能最成功。对WTS轨迹的监测将有助于为美国年轻人中这一新兴风险行为的医疗保健和政策提供信息。
Waterpipe tobacco smoking (WTS) is increasing in popularity despite evidence of harm and potential for dependence. Intervention development has been hampered by a lack of longitudinal, nationally-representative data on usage patterns and factors independently associated with WTS initiation. Therefore, we aimed to characterize key transitions between WTS states in a nationally-representative group of young adults, with particular attention to factors independently associated with initiation. Participants were randomly selected from a national probability-based panel representing 97% of the U.S. A total of 1785 adults ages 18–30 at baseline completed two web-based surveys 18 months apart in 2013 and 2014. Assessments included knowledge of waterpipe tobacco smoke composition, positive and negative attitudes towards WTS, normative beliefs, intention to use waterpipe, and WTS behavior. We used multivariable logistic regression to assess the association between predictive factors and subsequent WTS initiation. In fully-adjusted models, overall knowledge about toxicants associated with WTS was not associated with subsequent WTS initiation. Similarly, negative attitudes and normative beliefs were not associated WTS uptake. However, baseline positive attitudes were strongly and significantly associated with WTS initiation (Adjusted Odds Ratio [AOR]=1.7, 95% CI=1.2–2.3). Similarly, baseline intention to use WTS was strongly associated with subsequent initiation (AOR=7.0, 95% CI=3.5–13.7). Prevention efforts may be most successful if they target individuals with clear intentions to use WTS and challenge positive attitudes surrounding WTS. Surveillance of WTS trajectories will help inform healthcare and policy surrounding this emerging risk behavior among U.S. young adults.