Tobacco Product Use and Associated Factors Among Middle and High School Students - United States, 2019
Tobacco Product Use and Associated Factors Among Middle and High School Students - United States, 2019
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DOI：
10.15585/mmwr.ss6812a1
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发表时间：
2019-12-06
影响因子：
24.9
通讯作者：
Neff, Linda J.
中科院分区：
文献类型：
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作者：
Wang, Teresa W.;Gentzke, Andrea S.;Neff, Linda J.
问题/状况：烟草使用是美国可预防疾病、残疾和死亡的主要原因。大多数烟草产品的使用始于青春期。近年来，烟草产品已发展到包括各种有烟、无烟和电子产品。涵盖时期：2019 年。系统说明：全国青少年烟草调查 (NYTS) 是一项针对美国初中（6-8 年级）和高中（9-12 年级）学生的年度横断面、以学校为基础、自我管理的调查。采用三阶段整群抽样程序来生成在公立和私立学校就读的美国学生的全国代表性样本。 NYTS 是唯一一项针对美国中学生的全国代表性调查，专门关注烟草产品的使用模式和相关因素。 NYTS 旨在提供有关烟草产品使用的国家数据，并在 1999 年至 2009 年期间定期进行一次，自 2011 年起每年进行一次。NYTS 的数据用于支持综合烟草使用预防和控制计划的设计、实施和评估，并为烟草监管活动提供信息。自 1999 年成立至 2018 年，NYTS 一直通过纸笔问卷进行调查。 2019 年，NYTS 首次使用电子数据收集方法在学校进行管理。 CDC 吸烟与健康办公室与美国食品和药物管理局 (FDA) 烟草产品中心合作，分析了 2019 年 NYTS 的数据，以评估美国中学生的烟草产品使用模式和相关因素。总体而言，共完成并加权了 19,018 份问卷，代表约 2700 万学生。根据自我报告的年级水平，其中包括 8,837 份初中问卷（1,190 万名学生）和 10,097 份高中问卷（1,500 万名学生）；学校层面的分析中排除了 84 份缺少年级信息的问卷。 结果：2019 年，估计有 53.3% 的高中生（800 万）和 24.3% 的中学生（290 万）报告曾尝试过烟草产品。 31.2% 的高中生 (470 万) 和 12.5% 的中学生 (150 万) 报告当前（过去 30 天）使用烟草产品（即电子烟、卷烟、雪茄、无烟烟草、水烟袋、烟丝和比迪烟）。电子烟是目前最常使用的烟草产品，有 27.5% 的高中生（410 万）和 10.5% 的中学生（120 万）使用，其次是雪茄、香烟、无烟烟草、水烟和斗烟。烟草产品的使用也因性别和种族/民族而异。在每种烟草产品的当前使用者中，频繁使用烟草产品（过去 30 天中≥20 天）的流行率从雪茄吸烟者的 16.8% 到无烟烟草产品使用者的 34.1%。在当前每种烟草产品的用户中，电子烟是最常用的调味烟草产品（占当前电子烟用户的 68.8%）。在曾尝试过电子烟的学生中，最常选择的三个使用原因是“我对它们感到好奇”（55.3％）、“朋友或家人使用过它们”（30.8％）和“它们有薄荷、糖果、水果或巧克力等口味”（22.4％）。在从未使用过每种烟草产品的人中，电子烟（分别为 39.1% 和 45.0%）和香烟（分别为 37.0% 和 45.9%）的好奇心和敏感性（一种有助于确定未来烟草产品实验或使用的结构）最高。总体而言，在报告接触过经评估的烟草产品广告或促销潜在来源（去便利店、超市或加油站；使用互联网；看电视或流媒体服务或看电影；或阅读报纸或杂志）的学生中，86.3% 的学生报告接触过任何烟草产品的营销活动； 69.3% 的受访者表示接触过电子烟营销，81.7% 的受访者表示接触过卷烟或其他烟草产品营销。在所有学生中，认为间歇性使用烟草制品（有时使用，但不是每天使用）不会造成伤害或伤害很小的学生中，电子烟的比例为 28.2%，水烟袋的比例为 16.4%，无烟烟草制品的比例为 11.5%，卷烟的比例为 9.5%。在任何烟草产品的当前使用者中，24.7% 的人表示在过去 30 天内渴望使用烟草产品，13.7% 的人表示希望在醒来后 30 分钟内使用烟草产品。此外，57.8% 的当前烟草制品使用者表示，他们正在认真考虑戒掉使用所有烟草制品，57.5% 的使用者表示，他们因试图戒烟而已停止使用所有烟草制品超过 1 天。 解读：2019 年，大约四分之一的青少年 (23.0%) 在过去 30 天内使用过烟草制品。按学校级别计算，这大约占十分之三的高中生（31.2%）和大约八分之一的中学生（12.5%）。自2014年以来，电子烟一直是青少年最常用的烟草产品。重要的是，超过一半的当前青少年烟草产品使用者报告说，他们认真考虑在 2019 年戒掉所有烟草产品。然而，使用和开始使用的既定因素，包括口味的可用性、烟草产品营销的接触、好奇心和敏感性以及对烟草产品使用危害的误解，在 2019 年仍然普遍存在，并继续促进青少年使用烟草产品。公共卫生行动：通过包括 NYTS 在内的监测工作，持续监测所有形式的青少年烟草产品使用和相关因素非常重要制定国家、州和社区各级的公共卫生政策和行动。每个人，包括公共卫生专业人员、医疗保健提供者、政策制定者、教育工作者、父母和其他影响青少年的人，都可以帮助保护青少年免受所有烟草产品的危害。此外，全面、持续实施循证烟草控制策略，结合 FDA 对烟草产品的监管，对于减少美国青少年各种形式的烟草产品使用非常重要。
Problem/Condition: Tobacco use is the leading cause of preventable disease, disability, and death in the United States. Most tobacco product use begins during adolescence. In recent years, tobacco products have evolved to include various smoked, smokeless, and electronic products.Period Covered: 2019.Description of System: The National Youth Tobacco Survey (NYTS) is an annual, cross-sectional, school-based, self-administered survey of U.S. middle school (grades 6-8) and high school (grades 9-12) students. A three-stage cluster sampling procedure is used to generate a nationally representative sample of U.S. students attending public and private schools. NYTS is the only nationally representative survey of U.S. middle and high school students that focuses exclusively on tobacco product use patterns and associated factors. NYTS is designed to provide national data on tobacco product use and has been conducted periodically during 1999-2009 and annually since 2011. Data from NYTS are used to support the design, implementation, and evaluation of comprehensive tobacco use prevention and control programs and to inform tobacco regulatory activities. Since its inception in 1999 through 2018, NYTS had been conducted via paper and pencil questionnaires. In 2019, NYTS for the first time was administered in schools using electronic data collection methods. CDC's Office on Smoking and Health, in collaboration with the U.S. Food and Drug Administration's (FDA's) Center for Tobacco Products, analyzed data from the 2019 NYTS to assess tobacco product use patterns and associated factors among U.S. middle and high school students. Overall, 19,018 questionnaires were completed and weighted to represent approximately 27.0 million students. On the basis of self-reported grade level, this included 8,837 middle school questionnaires (11.9 million students) and 10,097 high school questionnaires (15.0 million students); 84 questionnaires with missing information on grade level were excluded from school-level analyses.Results: In 2019, an estimated 53.3% of high school students (8.0 million) and 24.3% of middle school students (2.9 million) reported having ever tried a tobacco product. Current (past 30-day) use of a tobacco product (i.e., electronic cigarettes [e-cigarettes], cigarettes, cigars, smokeless tobacco, hookahs, pipe tobacco, and bidis [small brown cigarettes wrapped in a leaf]) was reported by 31.2% of high school students (4.7 million) and 12.5% of middle school students (1.5 million). E-cigarettes were the most commonly cited tobacco product currently used by 27.5% of high school students (4.1 million) and 10.5% of middle school students (1.2 million), followed in order by cigars, cigarettes, smokeless tobacco, hookahs, and pipe tobacco. Tobacco product use also varied by sex and race/ethnicity. Among current users of each tobacco product, the prevalence of frequent tobacco product use (on >= 20 days of the preceding 30 days) ranged from 16.8% of cigar smokers to 34.1% of smokeless tobacco product users. Among current users of each individual tobacco product, e-cigarettes were the most commonly used flavored tobacco product (68.8% of current e-cigarette users). Among students who reported ever having tried e-cigarettes, the three most commonly selected reasons for use were "I was curious about them" (55.3%), "friend or family member used them" (30.8%), and "they are available in flavors, such as mint, candy, fruit, or chocolate" (22.4%). Among never users of each individual tobacco product, curiosity and susceptibility (a construct that can help to identify future tobacco product experimentation or use) was highest for e-cigarettes (39.1% and 45.0%, respectively) and cigarettes (37.0% and 45.9%, respectively). Overall, 86.3% of students who reported contact with an assessed potential source of tobacco product advertisements or promotions (going to a convenience store, supermarket, or gas station; using the Internet; watching television or streaming services or going to the movies; or reading newspapers or magazines) reported exposure to marketing for any tobacco product; 69.3% reported exposure to e-cigarette marketing and 81.7% reported exposure to marketing for cigarettes or other tobacco products. Among all students, perceiving no harm or little harm from intermittent tobacco product use (use on some days but not every day) was 28.2% for e-cigarettes, 16.4% for hookahs, 11.5% for smokeless tobacco products, and 9.5% for cigarettes. Among current users of any tobacco product, 24.7% reported experiencing cravings to use tobacco products during the past 30 days and 13.7% reported wanting to use a tobacco product within 30 minutes of waking. Moreover, 57.8% of current tobacco product users reported they were seriously thinking about quitting the use of all tobacco products and 57.5% reported they had stopped using all tobacco products for >= 1 day because they were trying to quit.Interpretation: In 2019, approximately one in four youths (23.0%) had used a tobacco product during the past 30 days. By school level, this represented approximately three in 10 high school students (31.2%) and approximately one in eight middle school students (12.5%). Since 2014, e-cigarettes have been the most commonly used tobacco product among youths. Importantly, more than half of current youth tobacco product users reported seriously thinking about quitting all tobacco products in 2019. However, established factors of use and initiation, including the availability of flavors, exposure to tobacco product marketing, curiosity and susceptibility, and misperceptions about harm from tobacco product use, remained prevalent in 2019 and continue to promote tobacco product use among youths.Public Health Action: The continued monitoring of all forms of youth tobacco product use and associated factors through surveillance efforts including NYTS is important to the development of public health policy and action at national, state, and community levels. Everyone, including public health professionals, health care providers, policymakers, educators, parents, and others who influence youths, can help protect youths from the harms of all tobacco products. In addition, the comprehensive and sustained implementation of evidence-based tobacco control strategies, combined with FDA's regulation of tobacco products, is important for reducing all forms of tobacco product use among U.S. youths.