Electronic cigarette use and smoking initiation among youth: a longitudinal cohort study
Electronic cigarette use and smoking initiation among youth: a longitudinal cohort study
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DOI：
10.1503/cmaj.161002
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发表时间：
2017-10-30
影响因子：
14.6
通讯作者：
Leatherdale, Scott T.
中科院分区：
文献类型：
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作者：
Hammond, David;Reid, Jessica L.;Leatherdale, Scott T.
背景技术背景：电子烟使用对吸烟开始的影响是一个极具争议的问题，可用于检查时间关联的纵向数据有限。我们在一个大型加拿大中学生队列中研究了电子烟的使用及其与1年随访时开始吸烟的关系。方法：我们分析了9-12年级学生的数据，这些学生参加了2波COMPASS，这是一项针对加拿大安大略和阿尔伯塔有目的抽样中学的队列研究，基线（2013/14）和1年随访（2014/15）。我们使用自我完成的调查评估了基线和随访时的吸烟和电子烟使用情况。我们使用广义线性混合效应模型来检查过去30天基线电子烟使用与纵向样本内波之间吸烟开始的相关性。2013/14至2014/15年度过去30天电子烟使用量增加（7.2% v.9.7%，p < 0.001），而过去30天吸烟略有下降（11.4% v.10.8%，p = 0.02）。在基线评估的44163名学生中，过去30天的电子烟使用与吸烟状况和吸烟易感性密切相关。在纵向样本中，（n = 19130），基线时过去30天使用电子烟与开始吸整支烟相关（调整的比值比[OR] 2.12，95%置信区间[CI] 1.68-2.66）和开始每日吸烟（调整OR 1.79，95%CI 1.41-2.28）。解释：电子烟使用与吸烟行为密切相关，包括随访时的吸烟开始。这种关联的因果性质尚不清楚，因为使用电子烟和传统香烟的共同因素也可能解释启动的时间顺序。
BACKGROUND: The influence of e-cigarette use on smoking initiation is a highly controversial issue, with limited longitudinal data available for examining temporal associations. We examined e-cigarette use and its association with cigarette-smoking initiation at 1-year follow-up within a large cohort of Canadian secondary school students.METHODS: We analyzed data from students in grades 9-12 who participated in 2 waves of COMPASS, a cohort study of purposefully sampled secondary schools in Ontario and Alberta, Canada, at baseline (2013/14) and 1-year follow-up (2014/15). We assessed cigarette smoking and e-cigarette use at baseline and follow-up using self-completed surveys. We used generalized linear mixed-effects models to examine correlates of past 30-day e-cigarette use at baseline and smoking initiation between waves within the longitudinal sample.RESULTS: Past 30-day e-cigarette use increased from 2013/14 to 2014/15 (7.2% v. 9.7%, p < 0.001), whereas past 30-day cigarette smoking decreased slightly (11.4% v. 10.8%, p = 0.02). Among the 44 163 students evaluated at baseline, past 30-day e-cigarette use was strongly associated with smoking status and smoking susceptibility. In the longitudinal sample (n = 19 130), past 30-day use of e-cigarettes at baseline was associated with initiation of smoking a whole cigarette (adjusted odds ratio [OR] 2.12, 95% confidence interval [CI] 1.68-2.66) and with initiation of daily smoking (adjusted OR 1.79, 95% CI 1.41-2.28) at follow-up.INTERPRETATION: E-cigarette use was strongly associated with cigarette smoking behaviour, including smoking initiation at follow-up. The causal nature of this association remains unclear, because common factors underlying the use of both e-cigarettes and conventional cigarettes may also account for the temporal order of initiation.