Association of Electronic Cigarette Use With Initiation of Combustible Tobacco Product Smoking in Early Adolescence.
Association of Electronic Cigarette Use With Initiation of Combustible Tobacco Product Smoking in Early Adolescence.
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电子烟的使用与青春期早期燃烧烟草产品吸烟的启动。
DOI：
10.1001/jama.2015.8950
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发表时间：
2015-08-18
期刊：
影响因子：
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通讯作者：
Audrain-McGovern J
中科院分区：
文献类型：
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作者：
Leventhal AM;Strong DR;Kirkpatrick MG;Unger JB;Sussman S;Riggs NR;Stone MD;Khoddam R;Samet JM;Audrain-McGovern J
在从未吸过可燃烟草的青少年中，接触电子香烟中的尼古丁是很常见的。评估从未尝试过可燃烟草的14岁青少年使用电子烟是否与开始使用三种可燃烟草产品（即香烟、雪茄和水烟）的风险相关。在基线（2013年秋季，9年级，平均年龄=14.1）、6个月（2014年春季，9年级）和12个月（2014年秋季，10年级）随访时对以学校为基础的队列进行纵向重复评估。通过方便抽样的方式招募了加州洛杉矶的10所公立高中。参与者是在基线时从未使用可燃烟草的学生，并接受了随访评估（N= 2530）。在每个时间点，学生在课堂数据收集过程中完成自我报告调查。基线时曾使用电子烟的自我报告（是/否）。在过去6个月内使用以下每种烟草制品的6个月和12个月的随访报告：(1)任何可燃烟草制品（是否）；(2)可燃香烟（是/否），(3)雪茄（是/否）；(4)水烟（是/否）；(5)可燃烟草制品数量（范围：0-3）。在6个月（30.7% vs. 8.1%， %差异[95% CI]=22.7[16.4, 28.9]）和12个月（25.2% vs. 9.3%， %差异[95% CI]= 15.9[10.0, 21.8]）的随访中，基线电子烟使用者（N=222）比从未使用者（N= 2308）在过去6个月使用任何可燃烟草制品的频率更高。在未经调整的分析中（OR[95% CI]=4.27[3.19, 5.71]）和在对吸烟的社会人口、环境和个人危险因素进行调整的分析中（OR[95% CI]=2.73[2.00, 3.73]），基线电子烟使用与更大的可燃烟草使用可能性相关。特定产品的分析显示，在两次随访中，电子烟的基线使用情况与可燃香烟（OR[95% CI]=2.65[1.73, 4.05]）、雪茄（OR[95% CI]=4.85[3.38, 6.96]）和水烟（OR[95% CI]=3.25[2.29, 4.62]）的使用和不同可燃产品的使用数量（OR[95% CI]=4.26[3.16, 5.74]）呈正相关。在洛杉矶的高中学生中，与不使用电子烟的学生相比，那些在基线时使用电子烟的学生在接下来的一年里更有可能报告开始吸食可燃烟草。需要进一步的研究来了解这种联系是否可能是因果关系。
Exposure to nicotine in electronic (e-) cigarettes is common among adolescents who report never having smoked combustible tobacco. To evaluate whether e-cigarette ever-use among 14-year-olds who have never tried combustible tobacco is associated with risk of initiating use of three combustible tobacco products (i.e., cigarettes, cigars, and hookah). Longitudinal repeated assessment of a school-based cohort at baseline (fall 2013, 9th grade, Mean age=14.1) and 6-month (spring 2014, 9th grade) and 12-month (fall 2014, 10th grade) follow-ups. Ten public high schools in Los Angeles, CA were recruited through convenience sampling. Participants were students who reported never using combustible tobacco at baseline and underwent follow-up assessment (N=2,530). At each time point, students completed self-report surveys during in-classroom data collections. Self-report of e-cigarette ever-use (yes/no) at baseline. Six- and 12-month follow-up reports of use of each of the following tobacco products within the prior 6 months: (1) any combustible tobacco product (yes/no); (2) combustible cigarettes (yes/no), (3) cigars (yes/no); (4) hookah (yes/no); and (5) number of combustible tobacco products (range: 0–3). Past 6-month use of any combustible tobacco product was more frequent in baseline e-cigarette ever-users (N=222) than never-users (N=2,308) at the 6-month (30.7% vs. 8.1%, % difference [95% CI]=22.7[16.4, 28.9]) and 12-month (25.2% vs. 9.3%, % difference [95% CI]= 15.9[10.0, 21.8]) follow-ups. Baseline ever e-cigarette use was associated with greater likelihood of combustible tobacco use averaged across the two follow-ups in unadjusted analyses (OR[95% CI]=4.27[3.19, 5.71]) and in analyses adjusted for sociodemographic, environmental, and intrapersonal risk factors for smoking (OR[95% CI]=2.73[2.00, 3.73]). Product-specific analyses showed that baseline e-cigarette ever-use was positively associated with combustible cigarette (OR[95% CI]=2.65[1.73, 4.05]), cigar (OR[95% CI]=4.85[3.38, 6.96]), and hookah (OR[95% CI]=3.25[2.29, 4.62]) use and number of different combustible products used (OR[95% CI]=4.26[3.16, 5.74]) averaged across the two follow-ups. Among high school students in Los Angeles, those who used electronic cigarettes at baseline compared with nonusers were more likely to report initiation of combustible tobacco smoking over the next year. Further research is needed to understand whether this association may be causal.