Miyazaki Yuki, Tabuchi Takahiro
School of Medicine, Osaka University, Suita, Osaka, Japan.
Center for Cancer Control and Statistics, Osaka Medical Center for Cancer and Cardiovascular Diseases, Higashinari-ku, Osaka, Japan.
PLoS One. 2018 Jan 12;13(1):e0191008. doi: 10.1371/journal.pone.0191008. eCollection 2018.
In addition to electronic cigarettes (e-cigarettes), tobacco companies have recently begun to sell heat-not-burn tobacco products, Ploom and iQOS in Japan. Previous research has reported an inverse association between combustible cigarette smoking and educational attainment, but little is known about the association for e-cigarettes, especially heat-not-burn tobacco products. Our objective was to analyze the relationship between educational attainment and e-cigarette and heat-not-burn tobacco use.
An internet survey (randomly sampled research agency panelists) in Japan.
A total of 7338 respondents aged 18-69 years in 2015 (3632 men and 3706women).
Adjusted odds ratios (ORs) of educational attainment for current smoking (combustible cigarettes), e-cigarette ever-use, and heat-not-burn ever-use were calculated by multivariable logistic regression models using covariates including socio-demographic factors. Stratified analyses according to smoking status (combustible cigarettes) were additionally performed for e-cigarette ever-use and heat-not-burn tobacco product ever-use.
Associations between educational attainment and e-cigarette ever-use or heat-not-burn tobacco ever-use are not straightforward, although these associations are not statistically significant except for one cell. For example, using "graduate school" education as a reference category, adjusted ORs for "high school" were 1.44 (95% confidence interval [CI]: 0.85-2.44) for e-cigarettes ever-use and 0.75 (95% CI:0.19-2.97) for heat-not-burn tobacco product ever-use. Among current smokers, compared with "graduate school" (reference), those with lower educational attainment showed 0.6 to 0.7 ORs for e-cigarette ever-use: e.g.,"4-year university"(OR = 0.54, 95% CI:0.24-1.24) and "high school" (OR = 0.69, 95% CI: 0.30-1.60). Among former smokers, lower education indicated higher ORs for both e-cigarettes and heat-not-burn tobacco ever-use.
This study provides baseline information on educational gradients of e-cigarette and heat-not-burn tobacco products, ever-use. As heat-not-burn tobacco products are increasing their market share in Japan, continuous monitoring of these products will be necessary.
除电子烟外，烟草公司最近开始在日本销售加热不燃烧烟草制品，如Ploom和iQOS。先前的研究报告了可燃香烟吸烟与教育程度之间存在负相关，但对于电子烟，尤其是加热不燃烧烟草制品之间的关联了解甚少。我们的目的是分析教育程度与电子烟及加热不燃烧烟草使用之间的关系。
在日本进行的一项网络调查（随机抽取研究机构的小组成员）。
2015年共有7338名年龄在18 - 69岁的受访者（3632名男性和3706名女性）。
通过多变量逻辑回归模型，使用包括社会人口学因素在内的协变量，计算当前吸烟（可燃香烟）、曾经使用电子烟和曾经使用加热不燃烧烟草制品的教育程度调整比值比（OR）。对于曾经使用电子烟和曾经使用加热不燃烧烟草制品，还根据吸烟状况（可燃香烟）进行了分层分析。
教育程度与曾经使用电子烟或曾经使用加热不燃烧烟草制品之间的关联并不直接，尽管除了一个单元格外，这些关联在统计学上并不显著。例如，以“研究生”教育为参照类别，“高中”学历者曾经使用电子烟的调整OR为1.44（95%置信区间[CI]：0.85 - 2.44），曾经使用加热不燃烧烟草制品的调整OR为0.75（95%CI：0.19 - 2.97）。在当前吸烟者中，与“研究生”（参照）相比，教育程度较低者曾经使用电子烟的OR为0.6至0.7：例如，“四年制大学”（OR = 0.54，95%CI：0.24 - 1.24）和“高中”（OR = 0.69，95%CI：0.30 - 1.60）。在曾经吸烟者中，较低的教育程度表明曾经使用电子烟和曾经使用加热不燃烧烟草制品的OR较高。
本研究提供了关于电子烟和加热不燃烧烟草制品曾经使用情况的教育梯度的基线信息。由于加热不燃烧烟草制品在日本的市场份额不断增加，有必要对这些产品进行持续监测。
