Department of Psychiatry, CMHC, Yale School of Medicine, New Haven, CT.
Department of Emergency Medicine, Yale School of Medicine, New Haven, CT.
Nicotine Tob Res. 2017 Dec 13;20(1):140-144. doi: 10.1093/ntr/ntw393.
Identifying youth at risk for future e-cigarette use is critical for informing prevention efforts. Prior research established measures of susceptibility to conventional cigarettes, and this study aimed to examine whether items adapted for e-cigarette susceptibility predicted subsequent e-cigarette use among never e-cigarette users.
Longitudinal school-wide survey data were collected from middle and high school students in Fall 2013 (wave 1) and Spring 2014 (wave 2). Among never e-cigarette users at wave 1 (n = 1720), e-cigarette susceptibility was measured by two items assessing anticipation of experimenting with e-cigarettes in the future and willingness to use an e-cigarette if offered by a best friend. Logistic regression models examined susceptibility as a predictor of e-cigarette initiation and past 30-day use 6 months later at wave 2. Models were clustered by school and controlled for sex, age, race, SES, and other substance use (alcohol, marijuana, and other tobacco).
In total, 8.9% (n = 153) of youth initiated e-cigarettes and 3.7% (n = 63) reported past 30-day use at wave 2. E-cigarette susceptibility was a significant independent predictor of subsequent initiation (OR = 4.27, 95% CI = 3.12-5.85) and past 30-day e-cigarette use (OR = 5.10, 95%CI = 3.38-7.68) 6 months later. Susceptible youth were more likely to be male, older, and have used alcohol, marijuana, or other tobacco products.
These findings provide initial support for adapting two susceptibility items to identify adolescents at risk for future e-cigarette use. Identifying strategies that are effective for targeting susceptible youth and preventing future e-cigarette use will be critical areas for future research.
More than a quarter of the sample who reported both a willingness to try e-cigarettes if offered by a best friend and anticipation of experimenting with e-cigarettes in the future went on to try e-cigarettes within the academic year, suggesting that targeting this group will be critical for preventing youth e-cigarette initiation. There were notable demographic differences between susceptible and non-susceptible youth, suggesting targeting e-cigarette prevention efforts to male students who have used other substances may be especially important for preventing future e-cigarette use. Research is needed to determine the most effective prevention strategies to reach susceptible youth.
识别未来使用电子烟的青少年风险至关重要，有助于为预防工作提供信息。先前的研究确立了对传统香烟易感性的衡量标准，本研究旨在检验针对电子烟易感性的项目是否能预测从未使用过电子烟的青少年在未来使用电子烟的情况。
2013 年秋季（第 1 波）和 2014 年春季（第 2 波）从中学和高中学生中收集了全范围学校的纵向调查数据。在第 1 波从未使用过电子烟的人群中（n = 1720），通过评估未来尝试使用电子烟的预期和如果好朋友提供电子烟就愿意使用的两个项目来衡量电子烟的易感性。使用逻辑回归模型检验易感性作为电子烟使用开始和 6 个月后第 2 波过去 30 天使用的预测指标。模型按照学校进行聚类，并控制了性别、年龄、种族、社会经济地位和其他物质使用（酒精、大麻和其他烟草）。
共有 8.9%（n = 153）的青少年开始使用电子烟，3.7%（n = 63）报告在第 2 波过去 30 天使用电子烟。电子烟易感性是随后开始使用电子烟（OR = 4.27，95%CI = 3.12-5.85）和过去 30 天使用电子烟（OR = 5.10，95%CI = 3.38-7.68）的显著独立预测指标。易感性青少年更可能是男性、年龄较大，并且使用过酒精、大麻或其他烟草制品。
这些发现初步支持采用两种易感性项目来识别有未来电子烟使用风险的青少年。确定针对易感青少年和预防未来电子烟使用的有效策略将是未来研究的关键领域。
报告愿意在朋友提供电子烟时尝试电子烟且对未来尝试电子烟有预期的青少年中，超过四分之一的人在学年内尝试了电子烟，这表明针对这一群体将是预防青少年使用电子烟的关键。在易感性和不易感性青少年之间存在显著的人口统计学差异，这表明针对已经使用过其他物质的男学生进行电子烟预防工作可能对预防未来使用电子烟特别重要。需要研究确定最有效的预防策略，以接触到易感青少年。
