Association Between Initial Use of e-Cigarettes and Subsequent Cigarette Smoking Among Adolescents and Young Adults: A Systematic Review and Meta-analysis.
Association Between Initial Use of e-Cigarettes and Subsequent Cigarette Smoking Among Adolescents and Young Adults: A Systematic Review and Meta-analysis.
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DOI：
10.1001/jamapediatrics.2017.1488
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发表时间：
2017-08-01
期刊：
影响因子：
26.1
通讯作者：
Sargent JD
中科院分区：
文献类型：
--
作者：
Soneji S;Barrington-Trimis JL;Wills TA;Leventhal AM;Unger JB;Gibson LA;Yang J;Primack BA;Andrews JA;Miech RA;Spindle TR;Dick DM;Eissenberg T;Hornik RC;Dang R;Sargent JD
电子烟对公共卫生的影响部分取决于电子烟的使用是否会影响吸烟的风险。对评估最初使用电子烟和随后吸烟的纵向研究进行系统回顾和荟萃分析。检索了2017年2月7日至2月17日期间的PubMed、EMBASE、科克伦图书馆、Web of Science、2016年尼古丁和烟草研究学会第22届年会摘要、2016年行为医学学会第37届年会和科学会议摘要以及2016年美国国立卫生研究院烟草监管科学计划会议。检索包括索引术语和文本词，以捕获从数据库建立到检索日期发表的文章中与电子烟和传统香烟相关的概念。纵向研究报告吸烟开始与曾经使用电子烟或过去30天吸烟与过去30天使用电子烟相关的比值比。ESTA产生了6959个独特的研究，其中9个符合纳入标准（包括17389名青少年和年轻人）。分别使用Newcastle-Ottawa量表和非随机干预研究工具中的偏倚风险评估研究质量和偏倚风险。使用随机效应荟萃分析汇总数据和估计值。在基线从不吸烟者中，基线和随访之间开始吸烟。在基线非过去30天的吸烟者中，过去30天的电子烟使用者，在随访时过去30天的吸烟。在17389名青少年和年轻成人中，基线时年龄范围为14 - 30岁，56.0%为女性。基线电子烟使用者开始吸烟的合并概率为30.4%，基线从未使用电子烟的为7.9%。随访时过去30天吸烟的汇总概率为基线过去30天电子烟使用者的21.5%和基线非过去30天电子烟使用者的4.6%。调整已知的吸烟的人口统计学、心理社会学和行为危险因素后，随后开始吸烟的合并优势比为3.62（95%CI，2.42-5.41），随访时过去30天吸烟的合并比值比为4.28（95% CI，2.52-727）过去30天的电子烟使用者与基线时非过去30天的电子烟使用者。在研究中观察到中等水平的异质性（I2 = 60.1%）。使用电子烟与随后开始吸烟和过去30天吸烟的风险更大相关。强有力的电子烟监管可能会抑制年轻人的使用，并可能限制未来吸烟的人口负担。
The public health implications of e-cigarettes depend, in part, on whether e-cigarette use affects the risk of cigarette smoking. To perform a systematic review and meta-analysis of longitudinal studies that assessed initial use of e-cigarettes and subsequent cigarette smoking. PubMed, EMBASE, Cochrane Library, Web of Science, the 2016 Society for Research on Nicotine and Tobacco 22nd Annual Meeting abstracts, the 2016 Society of Behavioral Medicine 37th Annual Meeting & Scientific Sessions abstracts, and the 2016 National Institutes of Health Tobacco Regulatory Science Program Conference were searched between February 7 and February 17, 2017. The search included indexed terms and text words to capture concepts associated with e-cigarettes and traditional cigarettes in articles published from database inception to the date of the search. Longitudinal studies reporting odds ratios for cigarette smoking initiation associated with ever use of e-cigarettes or past 30-day cigarette smoking associated with past 30-day e-cigarette use. Searches yielded 6959 unique studies, of which 9 met inclusion criteria (comprising 17 389 adolescents and young adults). Study quality and risk of bias were assessed using the Newcastle-Ottawa Scale and the Risk of Bias in Non-randomized Studies of Interventions tool, respectively. Data and estimates were pooled using random-effects meta-analysis. Among baseline never cigarette smokers, cigarette smoking initiation between baseline and follow-up. Among baseline non-past 30-day cigarette smokers who were past 30-day e-cigarette users, past 30-day cigarette smoking at follow-up. Among 17 389 adolescents and young adults, the ages ranged between 14 and 30 years at baseline, and 56.0% were female. The pooled probabilities of cigarette smoking initiation were 30.4% for baseline ever e-cigarette users and 7.9% for baseline never e-cigarette users. The pooled probabilities of past 30-day cigarette smoking at follow-up were 21.5% for baseline past 30-day e-cigarette users and 4.6% for baseline non-past 30-day e-cigarette users. Adjusting for known demographic, psychosocial, and behavioral risk factors for cigarette smoking, the pooled odds ratio for subsequent cigarette smoking initiation was 3.62 (95% CI, 2.42–5.41) for ever vs never e-cigarette users, and the pooled odds ratio for past 30-day cigarette smoking at follow-up was 4.28 (95% CI, 2.52–727) for past 30-day e-cigarette vs non-past 30-day e-cigarette users at baseline. A moderate level of heterogeneity was observed among studies (I2 = 60.1%). e-Cigarette use was associated with greater risk for subsequent cigarette smoking initiation and past 30-day cigarette smoking. Strong e-cigarette regulation could potentially curb use among youth and possibly limit the future population-level burden of cigarette smoking.
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10.1001/jama.2015.8950
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