Dutra Lauren M, Glantz Stanton A
Center for Tobacco Control Research and Education, and.
Center for Tobacco Control Research and Education, and
Pediatrics. 2017 Feb;139(2). doi: 10.1542/peds.2016-2450.
E-cigarette use is rapidly increasing among adolescents in the United States, with some suggesting that e-cigarettes are the cause of declining youth cigarette smoking. We hypothesized that the decline in youth smoking changed after e-cigarettes arrived on the US market in 2007.
Data were collected by using cross-sectional, nationally representative school-based samples of sixth- through 12th-graders from 2004-2014 National Youth Tobacco Surveys (samples ranged from 16 614 in 2013 to 25 324 in 2004). Analyses were conducted by using interrupted time series of ever (≥1 puff) and current (last 30 days) cigarette smoking. Logistic regression was used to identify psychosocial risk factors associated with cigarette smoking in the 2004-2009 samples; this model was then applied to estimate the probability of cigarette smoking among cigarette smokers and e-cigarette users in the 2011-2014 samples.
Youth cigarette smoking decreased linearly between 2004 and 2014 (P = .009 for ever smoking and P = .05 for current smoking), with no significant change in this trend after 2009 (P = .57 and .23). Based on the psychosocial model of smoking, including demographic characteristics, willingness to wear clothing with a tobacco logo, living with a smoker, likelihood of smoking in the next year, likelihood of smoking cigarettes from a friend, and use of tobacco products other than cigarettes or e-cigarettes, the model categorized <25% of current e-cigarette-only users (between 11.0% in 2012 and 23.1% in 2013) as current smokers.
The introduction of e-cigarettes was not associated with a change in the linear decline in cigarette smoking among youth. E-cigarette-only users would be unlikely to have initiated tobacco product use with cigarettes.
在美国，青少年使用电子烟的现象正在迅速增加，一些人认为电子烟是青少年吸烟率下降的原因。我们假设2007年电子烟进入美国市场后，青少年吸烟率的下降情况发生了变化。
数据收集自2004 - 2014年全国青少年烟草调查中具有全国代表性的6至12年级学生的横断面学校样本（样本数量从2013年的16614人到2004年的25324人不等）。分析采用曾经（≥1口）和当前（过去30天）吸烟情况的中断时间序列进行。逻辑回归用于确定2004 - 2009年样本中与吸烟相关的心理社会风险因素；然后将该模型应用于估计2011 - 2014年样本中吸烟者和电子烟使用者吸烟的概率。
2004年至2014年间，青少年吸烟率呈线性下降（曾经吸烟的P = 0.009，当前吸烟的P = 0.05），2009年后这一趋势没有显著变化（P = 0.57和0.23）。基于吸烟的心理社会模型，包括人口统计学特征、愿意穿着带有烟草标志的衣服、与吸烟者同住、来年吸烟的可能性、从朋友处获得香烟吸烟的可能性以及使用除香烟或电子烟之外的烟草制品，该模型将不到25%的仅使用电子烟的当前使用者（2012年为11.0%，2013年为23.1%）归类为当前吸烟者。
电子烟的引入与青少年吸烟率的线性下降变化无关。仅使用电子烟的使用者不太可能最初是从吸烟开始使用烟草制品的。
