Department of Social and Behavioral Sciences, NYU College of Global Public Health, New York, NY.
Schroeder Institute at Truth Initiative, Washington, DC.
Nicotine Tob Res. 2020 Apr 21;22(5):647-654. doi: 10.1093/ntr/ntz030.
The objective of this study was to describe tobacco and nicotine product use state transition probabilities among youth and young adults over time.
A national sample of young adult tobacco product users and nonusers between the ages of 18 and 34 years at baseline was surveyed at 6-month intervals for 3 years. Use and nonuse states were defined as mutually exclusive categories based on self-reported, past 30-day use of the various products. Never use, noncurrent use, and current use of combustible, noncombustible tobacco, and electronic cigarette (e-cigarette) products was assessed at each interval. A multistate model was fit to estimate transition probabilities between states and length of stay within each state.
After 6 months, same-state transition probabilities were high for all use states (0.76-0.96), except for dual product use (0.48). After 3 years, transition probabilities were smaller and tended to converge toward combustible product use for baseline e-cigarette (0.42), combustible (0.51), and dual product users (0.52). Age was inversely associated with transition risk from never or noncurrent use to use of combustible or e-cigarette products.
Never and noncurrent users, followed by combustible product users, were most likely to remain in those states throughout the 3-year observation interval. Users of any tobacco or e-cigarette product at baseline were most likely to transition to combustible product use or noncurrent use by the final follow-up.
This study describes the probability of transitioning between various states of tobacco product use, including never and no current use, over a span of 3 years in a sample of young adults. This type of longitudinal description, which includes all tobacco product use states, is lacking in most studies that tend to focus on one or only a few products. The results suggest that it is important to assess outcomes over a sufficiently long period to capture true variability in patterns of product use.
本研究的目的是描述青少年和年轻成年人随时间推移的烟草和尼古丁产品使用状态转变概率。
在基线时，对年龄在 18 至 34 岁之间的成年烟草产品使用者和非使用者进行了一项全国性样本调查，每 6 个月进行一次，为期 3 年。使用和非使用状态是根据自我报告的过去 30 天内各种产品的使用情况定义的互斥类别。在每个时间间隔内评估从未使用、非当前使用和当前使用可燃、不可燃烟草和电子烟 (e-cigarette) 产品的情况。拟合多状态模型以估计状态之间的转移概率和每个状态内的停留时间。
6 个月后，所有使用状态的同状态转移概率都很高（0.76-0.96），除了双重产品使用（0.48）。3 年后，转移概率较小，并且基线电子烟（0.42）、可燃产品（0.51）和双重产品使用者（0.52）的转移概率趋于向可燃产品使用靠拢。年龄与从不或非当前使用向可燃或电子烟产品使用的转变风险呈负相关。
从未使用或非当前使用，然后是可燃产品使用者，在整个 3 年观察期内最有可能保持在这些状态。在基线时使用任何烟草或电子烟产品的人，在最后一次随访时最有可能过渡到可燃产品使用或非当前使用。
本研究描述了在年轻成年人样本中，在 3 年内各种烟草产品使用状态（包括从未使用和当前未使用）之间转变的概率。这种包括所有烟草产品使用状态的纵向描述在大多数倾向于关注一种或几种产品的研究中是缺乏的。结果表明，评估结果需要足够长的时间才能捕获产品使用模式的真实变化，这一点很重要。
