Addictions Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK; UK Centre for Tobacco and Alcohol Studies, Clinical Sciences Building, University of Nottingham, Nottingham, UK.
Addictions Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK; UK Centre for Tobacco and Alcohol Studies, Clinical Sciences Building, University of Nottingham, Nottingham, UK.
J Adolesc Health. 2018 May;62(5):539-547. doi: 10.1016/j.jadohealth.2017.11.301. Epub 2018 Mar 2.
Electronic cigarette (e-cigarette) use is associated with smoking initiation among young people; however, it is also possible that smoking is associated with e-cigarette initiation. This study explores these associations among young people in Great Britain.
A longitudinal survey of 1,152 11- to 18-year-olds was conducted with baseline in April 2016 and follow-up between August and October 2016. Logistic regression models and causal mediation analyses assessed whether (1) ever e-cigarette use and escalation were associated with smoking initiation (ever smoking at follow-up) among baseline never smokers (n = 923), and (2) ever smoking and escalation were associated with e-cigarette initiation (ever e-cigarette use at follow-up) among baseline never e-cigarette users (n = 1,020).
At baseline, 19.8% were ever smokers and 11.4% were ever e-cigarette users. Respondents who were ever e-cigarette users (vs. never users, 53% vs. 8%, odds ratio [OR] = 11.89, 95% confidence interval [CI] = 3.56-39.72) and escalated their e-cigarette use (vs. did not, 41% vs. 8%, OR = 7.89, 95% CI = 3.06-20.38) were more likely to initiate smoking. Respondents who were ever smokers (vs. never smokers, 32% vs. 4%, OR = 3.54, 95% CI = 1.68-7.45) and escalated their smoking (vs. did not, 34% vs. 6%, OR = 5.79, 95% CI = 2.55-13.15) were more likely to initiate e-cigarette use. There was a direct effect of ever e-cigarette use on smoking initiation (OR = 1.34, 95% CI = 1.05-1.72), and ever smoking on e-cigarette initiation (OR = 1.08, 95% CI = 1.01-1.17); e-cigarette and smoking escalation, respectively, did not mediate these effects.
Among young people in Great Britain, ever e-cigarette use is associated with smoking initiation, and ever smoking is associated with e-cigarette initiation.
电子烟（e-cigarette）的使用与年轻人吸烟的开始有关；然而，也有可能是吸烟与电子烟的使用开始有关。本研究探索了英国年轻人中的这些关联。
对 11 至 18 岁的 1152 名年轻人进行了一项纵向调查，基线调查于 2016 年 4 月进行，后续调查于 2016 年 8 月至 10 月进行。使用逻辑回归模型和因果中介分析评估了以下情况：（1）基线时从未吸烟的人群中，电子烟的使用（随访时的吸烟）和升级与吸烟开始（随访时的吸烟）是否相关（从未吸烟者 n=923）；（2）基线时从未使用过电子烟的人群中，吸烟（随访时的电子烟使用）和升级与电子烟的开始（随访时的电子烟使用）是否相关（从未使用过电子烟的 n=1020）。
基线时，19.8%的人吸烟，11.4%的人使用电子烟。与从未使用过电子烟的人相比，曾经使用过电子烟的人（53%比 8%，比值比 [OR] = 11.89，95%置信区间 [CI] = 3.56-39.72）和电子烟使用升级的人（41%比 8%，OR = 7.89，95% CI = 3.06-20.38）更有可能开始吸烟。与从未吸烟者相比，曾经吸烟者（32%比 4%，OR = 3.54，95% CI = 1.68-7.45）和吸烟升级的人（34%比 6%，OR = 5.79，95% CI = 2.55-13.15）更有可能开始使用电子烟。电子烟的使用与吸烟的开始呈直接相关（OR = 1.34，95% CI = 1.05-1.72），而吸烟与电子烟的开始也呈直接相关（OR = 1.08，95% CI = 1.01-1.17）；电子烟和吸烟的升级分别没有对这些影响产生中介作用。
在英国的年轻人中，电子烟的使用与吸烟的开始有关，而吸烟与电子烟的开始有关。
