Association of Electronic Cigarette Use With Subsequent Initiation of Tobacco Cigarettes in US Youths
Association of Electronic Cigarette Use With Subsequent Initiation of Tobacco Cigarettes in US Youths
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DOI：
10.1001/jamanetworkopen.2018.7794
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发表时间：
2019-02-01
影响因子：
13.8
通讯作者：
Stokes, Andrew
中科院分区：
文献类型：
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作者：
Berry, Kaitlyn M.;Fetterman, Jessica L.;Stokes, Andrew
电子烟的使用（电子烟）和其他非香烟烟草产品可能会增加吸烟开始的几率，即使是在低风险的youth. ObjectiveTo评估先前使用电子烟和其他烟草产品使用与随后在2年内开始吸烟的相关性。设计，设置和参与者在这项前瞻性队列研究中，烟草与健康研究（2013-2016）第1波至第3波的数据用于评估12至15岁从未使用过香烟，电子烟或其他烟草产品的青少年。这是一项对美国人口的全国代表性研究。数据分析于2018年进行。EXPOSURES首次使用非卷烟烟草产品（无、电子烟或其他烟草产品）。主要结果和指标在第3波时曾经吸烟和目前吸烟。（N = 6123），受访者中49.5%为女性; 54.1%为非西班牙裔白色人;平均（SD）年龄为13.4（1.2）岁。其中，8.6%的人报告电子烟是他们的第一种烟草产品，而5.0%的人报告首先使用另一种非卷烟产品; 3.3%的人报告首先使用卷烟。在第三波中，电子烟使用者（20.5%）的吸烟率高于没有吸烟史的年轻人（3.8%）。与既往未使用烟草相比，既往使用电子烟的几率是既往吸烟几率的4倍以上（比值比，4.09; 95%CI，2.97-5.63），是当前吸烟几率的近3倍（比值比，2.75; 95%CI，1.60-4.73）。与既往无烟草使用相比，既往使用其他烟草产品与随后的既往吸烟（OR，3.84; 95%CI，2.63-5.63）和当前吸烟（OR，3.43; 95%CI，1.88-6.26）相关。在低风险青少年中，先前使用电子烟与开始吸烟的关联更强（OR，8.57; 95%CI，3.87-18.97），这是先前使用其他产品所未见的模式。在2013年和2014年以及2015年和2016年的两年中，21.8%的新香烟曾经使用过（178 850名青少年）和15.3%的目前吸烟者（43446名青少年）中年龄在12至15岁的美国青少年可能归因于先前的电子烟使用。吸烟与吸烟开始和吸烟的风险增加有关，特别是在低风险青年中。在人口层面上，电子烟的使用可能是青少年开始吸烟的原因之一。
IMPORTANCE The use of electronic cigarettes (e-cigarettes) and other noncigarette tobacco products may increase the odds of cigarette initiation, even among low-risk youths.OBJECTIVE To evaluate the associations of prior e-cigarette use and other tobacco product use with subsequent cigarette initiation within 2 years of follow-up.DESIGN, SETTING, AND PARTICIPANTS In this prospective cohort study, data from waves 1 through 3 of the Population Assessment of Tobacco and Health Study (2013-2016) were used to assess youths aged 12 to 15 years who had never used cigarettes, e-cigarettes, or other tobacco products at wave 1. This was a nationally representative study of the US population. Data analysis was conducted in 2018.EXPOSURES First noncigarette tobacco product used (none, e-cigarette, or other tobacco product) between wave 1 and wave 3.MAIN OUTCOMES AND MEASURES Ever cigarette use and current cigarette use at wave 3.RESULTS In the sample (N = 6123), respondents were 49.5% female; 54.1% non-Hispanic, white; and the mean (SD) age was 13.4 (1.2) years. Of these, 8.6% reported e-cigarettes as their first tobacco product, while 5.0% reported using another noncigarette product first; 3.3% reported using cigarettes first. Cigarette use at wave 3 was higher among prior e-cigarette users (20.5%) compared with youths with no prior tobacco use (3.8%). Prior e-cigarette use was associated with more than 4 times the odds of ever cigarette use (odds ratio, 4.09; 95% CI, 2.97-5.63) and nearly 3 times the odds of current cigarette use (odds ratio, 2.75; 95% CI, 1.60-4.73) compared with no prior tobacco use. Prior use of other tobacco products was similarly associated with subsequent ever cigarette use (OR, 3.84; 95% CI, 2.63-5.63) and current cigarette use (OR, 3.43; 95% CI, 1.88-6.26) compared with no prior tobacco use. The association of prior e-cigarette use with cigarette initiation was stronger among low-risk youths (OR, 8.57; 95% CI, 3.87-18.97), a pattern not seen for prior other product use. Over the 2 years between 2013 and 2014 and 2015 and 2016, 21.8% of new cigarette ever use (178 850 youths) and 15.3% of current cigarette use (43 446 youths) among US youths aged 12 to 15 years may be attributable to prior e-cigarette use.CONCLUSIONS AND RELEVANCE This study's findings support the notion that e-cigarette use is associated with increased risk for cigarette initiation and use, particularly among low-risk youths. At the population level, the use of e-cigarettes may be a contributor to the initiation of cigarette smoking among youths.