Progression to Traditional Cigarette Smoking After Electronic Cigarette Use Among US Adolescents and Young Adults
Progression to Traditional Cigarette Smoking After Electronic Cigarette Use Among US Adolescents and Young Adults
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DOI：
10.1001/jamapediatrics.2015.1742
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发表时间：
2015-11-01
期刊：
影响因子：
26.1
通讯作者：
Sargent, James D.
中科院分区：
文献类型：
--
作者：
Primack, Brian A.;Soneji, Samir;Sargent, James D.
电子香烟（e-cigarettes）可以帮助吸烟者减少传统可燃香烟的使用。然而，从未吸过传统香烟的青少年和年轻人现在正在使用电子烟，这些人可能有随后发展为传统香烟smoking.Objective的风险，以确定非吸烟和非易感青少年和年轻人中基线使用电子烟是否与随后沿着既定轨迹发展为传统香烟smoking相关。在这项纵向队列研究中，694名年龄在16至26岁之间的美国参与者从未吸烟，并且对吸烟态度不敏感，他们完成了2012年10月1日至2014年5月1日的基线调查，关于2012-2013年的吸烟情况。一年后重新评估。分析时间为2014年7月1日至2015年3月1日。使用多项logistic回归评估基线电子烟使用与吸烟之间的独立关联，控制性别，年龄，种族/民族，母亲教育水平，感觉寻求倾向，父母吸烟和朋友吸烟。进行敏感性分析，采用不同的方法来处理缺失数据和撤回。主要结局和指标：吸烟进展，使用3个特定状态沿着轨迹定义：非易感非吸烟者、易感非吸烟者和吸烟者。在694名受访者中，374名（53.9%）是女性，531名（76.5%）是非西班牙裔白色。在基线时，16名参与者（2.3%）使用电子烟。在为期一年的随访中，16名电子烟使用者中有11名和678名未使用电子烟的人中有128名（18.9%）逐渐吸烟。在主要的完全校正模型中，基线电子烟使用与吸烟进展（校正的比值比[AOR]，8.3; 95%CI，1.2-58.6）和非吸烟者的易感性（AOR，8.5; 95%CI，1.3-57.2）独立相关。敏感性分析显示一致的结果的显着性水平和略大幅度的AORs.Conclusions和相关性在这个国家的美国青少年和年轻人的样本中，在基线使用电子烟与传统香烟吸烟的进展。这些发现支持限制销售的法规，并降低电子烟对青少年和年轻人的吸引力。
IMPORTANCE Electronic cigarettes (e-cigarettes) may help smokers reduce the use of traditional combustible cigarettes. However, adolescents and young adults who have never smoked traditional cigarettes are now using e-cigarettes, and these individuals may be at risk for subsequent progression to traditional cigarette smoking.OBJECTIVE To determine whether baseline use of e-cigarettes among nonsmoking and nonsusceptible adolescents and young adults is associated with subsequent progression along an established trajectory to traditional cigarette smoking.DESIGN, SETTING, AND PARTICIPANTS In this longitudinal cohort study, a national US sample of 694 participants aged 16 to 26 years who were never cigarette smokers and were attitudinally nonsusceptible to smoking cigarettes completed baseline surveys from October 1, 2012, to May 1, 2014, regarding smoking in 2012-2013. They were reassessed 1 year later. Analysis was conducted from July 1, 2014, to March 1, 2015. Multinomial logistic regression was used to assess the independent association between baseline e-cigarette use and cigarette smoking, controlling for sex, age, race/ethnicity, maternal educational level, sensation-seeking tendency, parental cigarette smoking, and cigarette smoking among friends. Sensitivity analyses were performed, with varying approaches to missing data and recanting.EXPOSURES Use of e-cigarettes at baseline. MAIN OUTCOMES AND MEASURES Progression to cigarette smoking, defined using 3 specific states along a trajectory: nonsusceptible nonsmokers, susceptible nonsmokers, and smokers. Individuals who could not rule out smoking in the future were defined as susceptible.RESULTS Among the 694 respondents, 374 (53.9%) were female and 531 (76.5%) were non-Hispanic white. At baseline, 16 participants (2.3%) used e-cigarettes. Over the 1-year follow-up, 11 of 16 e-cigarette users and 128 of 678 of those who had not used e-cigarettes (18.9%) progressed toward cigarette smoking. In the primary fully adjusted models, baseline e-cigarette use was independently associated with progression to smoking (adjusted odds ratio [AOR], 8.3; 95% CI, 1.2-58.6) and to susceptibility among nonsmokers (AOR, 8.5; 95% CI, 1.3-57.2). Sensitivity analyses showed consistent results in the level of significance and slightly larger magnitude of AORs.CONCLUSIONS AND RELEVANCE In this national sample of US adolescents and young adults, use of e-cigarettes at baseline was associated with progression to traditional cigarette smoking. These findings support regulations to limit sales and decrease the appeal of e-cigarettes to adolescents and young adults.