Association Between Adolescent Blunt Use and the Uptake of Cigars
Association Between Adolescent Blunt Use and the Uptake of Cigars
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DOI：
10.1001/jamanetworkopen.2019.17001
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发表时间：
2019-12-01
影响因子：
13.8
通讯作者：
Sterling, Kymberle Landrum
中科院分区：
文献类型：
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作者：
Audrain-McGovern, Janet;Rodriguez, Daniel;Sterling, Kymberle Landrum
近三分之二的青少年吸烟者也使用雪茄。虽然青少年同时使用钝器和雪茄是普遍的，青少年钝性吸烟是否与目前使用雪茄的进展有关（过去30天的使用）和使用频率的增加是未知的。（过去30天使用）和使用天数增加（在过去30天内）在随后的24个月内，与从未使用过钝头器的青少年进行比较。在这项对宾夕法尼亚州费城以外的4所公立高中的青少年进行的前瞻性队列研究中，在基线（2016年秋季，9年级开始）和随后的24个月（2018年秋季，11年级开始）每隔6个月进行一次课堂调查。数据分析于2019年9月和10月进行。EXPOSURES基线时终生（曾经）钝性使用的自我报告（14岁）。主要结果和衡量标准（过去30天内使用）和使用频率的增加在随后的24个月中，1825名参与者中，907名参与者使用了30天（过去30天使用的天数）。（49.7%）为女性，1330例（72.9%）为白色，376例（20.6%）为西班牙裔;基线时的平均（SD）年龄为14.38（0.55）岁。总共有257名参与者（14.0%）报告曾使用钝性器械。混合效应模型显示，基线时曾钝性使用与从未钝性使用与进展至目前使用雪茄相关（过去30天用途：比值比，22.66; 95% CI，11.34 - 45.27），但在随后24个月内使用天数未增加（β = 0.13; 95%CI，-0.17至0.43）。结论和相关性这些发现强调了青少年中钝性使用可能对随后的雪茄使用造成的风险。针对大麻和雪茄的政策和公共卫生运动对于减少青少年的钝性使用和雪茄使用至关重要。
IMPORTANCE Almost two-thirds of adolescents who smoke blunts also report using cigars. Although adolescent co-use of blunts and cigars is prevalent, whether adolescent blunt use is associated with progression to current cigar use (past 30-day use) and increased frequency of use is unknown.OBJECTIVE To determine whether adolescent use of blunts is associated with progression to cigar use (past 30-day use) and increased number of days used (in the past 30 days) across the subsequent 24 months compared with adolescents who have never used blunts.DESIGN, SETTING, AND PARTICIPANTS In this prospective cohort study of adolescents from 4 public high schools outside of Philadelphia, Pennsylvania, in-classroom surveys were administered at baseline (fall 2016, beginning of 9th grade) and at 6-month intervals for the following 24 months (fall 2018, beginning of 11th grade). Data analyses were conducted in September and October 2019.EXPOSURES Self-report of lifetime (ever) blunt use at baseline (age 14 years).MAIN OUTCOMES AND MEASURES Progression to current cigar use (use in the past 30 days) and escalation in the frequency of use (number of days used in the past 30 days) across the subsequent 24 months.RESULTS Of 1825 participants, 907 (49.7%) were female, 1330 (72.9%) were white, and 376 (20.6%) were Hispanic; the mean (SD) age at baseline was 14.38 (0.55) years. In all, 257 participants (14.0%) reported ever blunt use. Mixed-effects models revealed that ever blunt use at baseline vs never blunt use was associated with progression to current cigar use (past 30 days use: odds ratio, 22.66; 95% CI, 11.34-45.27) but not escalation in the number of days used across the following 24 months (beta = 0.13; 95% CI, -0.17 to 0.43).CONCLUSIONS AND RELEVANCE These findings highlight the risk that blunt use may pose for subsequent cigar use among adolescents. Policies and public health campaigns addressing marijuana as well as cigars will be important to reduce adolescent blunt use and cigar use.