Division of General Pediatrics and Adolescent Health, Department of Pediatrics, Medical School, University of Minnesota, Minneapolis, MN.
Office of Statewide Health Improvement Initiative, Minnesota Department of Health, Saint Paul, MN.
Nicotine Tob Res. 2020 Jan 27;22(1):124-129. doi: 10.1093/ntr/nty178.
Cigarette use has dropped dramatically among youth since 2013, but smoking-related disparities persist. We examine who still smokes in the context of declining smoking rates. Using the Minnesota Student Survey, we examine adverse childhood experiences (ACEs) and cigarette use in 2013 and 2016. We assess how cigarette use rates changed, how ACEs relate to cigarette use, and the degree to which youth with ACEs comprise the current smoking population.
Data came from the 2013 and 2016 Minnesota Student Survey. We assessed past 30-day any and daily cigarette use statewide and among youth with no ACEs, high cumulative ACEs, and seven separate ACEs. We used descriptive statistics and multivariate logistic regression analyses.
Cigarette use significantly declined for all groups from 2013 to 2016. Youth with no ACEs exhibited the highest percent decrease in any and daily cigarette use. Youth with ACEs were more likely to report any and daily cigarette use in 2013 and 2016, adjusting for demographics. Among youth with any 30-day use, the rate of ACEs increased from 2013 to 2016. Youth with ACEs disproportionately accounted for youth smoking populations in 2013 and 2016. For example, although 16% of all youth experienced parental incarceration, approximately 43% and 55% of youth with any and daily cigarette use experienced parental incarceration in 2016, respectively.
Cigarette use declined from 2013 to 2016 for all Minnesota youth, but the decline among youth with no ACEs was faster than those with ACEs. Youth with ACEs now account for an increasingly high percent of youth smokers.
Even though cigarette use is declining among Minnesota youth, the decline among youth without ACEs is faster than the decline among youth with ACEs. Youth with ACEs disproportionately account for all youth smokers, and this disproportionality has increased since 2013. Tobacco control efforts should focus on youth with ACEs, and parental incarceration is a specific ACE that warrants attention. Rates of parental incarceration remain high in the United States and youth who experience parental incarceration now account for a near majority of current youth smokers. Future research should consider mechanisms for the ACE-smoking relationship and emerging tobacco products (eg, electronic cigarettes).
自 2013 年以来，青少年的吸烟率大幅下降，但与吸烟相关的差距仍然存在。我们研究了在吸烟率下降的情况下，谁还在吸烟。本研究使用明尼苏达州学生调查（Minnesota Student Survey），调查了 2013 年和 2016 年青少年的不良童年经历（adverse childhood experiences，ACEs）与吸烟之间的关系。我们评估了吸烟率的变化情况、ACEs 与吸烟的关系，以及 ACEs 青少年在当前吸烟人群中所占的比例。
数据来自 2013 年和 2016 年的明尼苏达州学生调查。我们评估了全州范围内以及无 ACEs、高 ACEs 累计量和七种 ACEs 的青少年中过去 30 天内任何一天和每天吸烟的情况。我们使用描述性统计和多变量逻辑回归分析。
2013 年至 2016 年，所有群体的吸烟率均显著下降。无 ACEs 的青少年任何和每日吸烟的百分比下降幅度最大。有 ACEs 的青少年在 2013 年和 2016 年更有可能报告任何和每日吸烟，这与人口统计学因素有关。在有任何 30 天吸烟史的青少年中，ACEs 的发生率从 2013 年到 2016 年有所增加。有 ACEs 的青少年在 2013 年和 2016 年都不成比例地占青少年吸烟人群的比例。例如，尽管有 16%的青少年经历过父母入狱，但在 2016 年，有任何和每日吸烟的青少年中，约有 43%和 55%的青少年经历过父母入狱。
从 2013 年到 2016 年，明尼苏达州所有青少年的吸烟率都有所下降，但无 ACEs 的青少年下降速度快于有 ACEs 的青少年。现在，有 ACEs 的青少年在青少年吸烟者中所占的比例越来越高。
尽管明尼苏达州青少年的吸烟率正在下降，但无 ACEs 的青少年下降速度快于有 ACEs 的青少年。有 ACEs 的青少年不成比例地占所有青少年吸烟者的比例，而且这一比例自 2013 年以来有所增加。烟草控制工作应重点关注有 ACEs 的青少年，父母入狱是一个值得关注的特定 ACE。在美国，父母入狱的比例仍然很高，经历过父母入狱的青少年现在几乎占当前青少年吸烟者的一半。未来的研究应考虑 ACE 与吸烟之间关系的机制和新兴烟草产品（如电子烟）。
