Critical Public Health Research Group, Prevention Research Center, Berkeley, CA.
Institute for Scientific Analysis, Alameda, CA.
Nicotine Tob Res. 2020 Apr 21;22(5):722-727. doi: 10.1093/ntr/ntz028.
Existing research on youth's adoption of alternative nicotine delivery systems (ANDS) has focused on identifying pathways of nicotine product use, specifically examining whether vaping encourages progression to smoking. Few studies have considered other pathways of initiation. Qualitative studies suggest that meanings of vaping vary significantly, suggestive of the need for a more nuanced understanding of the role of vaping for youth with different pathways into vaping and smoking.
We conducted in-depth qualitative interviews with 49 Californian youth between 15 and 25 years old who reported ever vaping nicotine to gain a deeper understanding of their initiation pathways of vaping and smoking, paying special attention to youth's experiences and reasons for ANDS initiation and use. Categorizing participants into initiation pathways by self-reported use and age of initiation of ANDS and cigarettes, we then compared the meaning and role of vaping across three distinct pathways of use: (1) smoking to vaping, (2) vaping to smoking, and (3) vaping only.
The most common pathway reported was smoking to vaping (74%), eight participants began vaping before smoking, and five participants reported only vaping but never smoking. Analysis of participants' narratives emphasized that youth in our study, regardless of initiation pathway, were generally aware of the health consequences of smoking and negotiated their use of nicotine products considering relative risks.
Findings from this study suggest that ANDS serve as a transitional tool for youth who are keenly aware of the health consequences of smoking, thus challenging conventional discourses about ANDS as a threat to youth's health.
This qualitative study queries concerns about the potential of alternative nicotine delivery systems (ANDS) to serve as a gateway into cigarette smoking for youth and young adults. Findings suggest that most of the youth participants discussed and considered relative risks in their pathways of initiation, highlighting the need to acknowledge harm reduction in constructing public health messaging and policies for smoking cessation.
现有关于青少年采用替代尼古丁输送系统（ANDS）的研究集中在确定尼古丁产品使用的途径上，特别是研究蒸气是否会鼓励吸烟。很少有研究考虑其他的起始途径。定性研究表明，蒸气的含义有很大的差异，这表明需要更细致地了解不同途径进入蒸气和吸烟的青少年使用蒸气的作用。
我们对 49 名年龄在 15 岁至 25 岁之间的加州青少年进行了深入的定性访谈，这些青少年报告曾经吸食尼古丁，以更深入地了解他们吸食尼古丁的起始途径和吸烟，特别关注青少年吸食 ANDS 和吸烟的经验和原因。根据自我报告的 ANDS 和香烟的使用和起始年龄将参与者分类为起始途径，然后比较了三种不同使用途径下蒸气的意义和作用：（1）吸烟转为蒸气，（2）蒸气转为吸烟，以及（3）只蒸气不吸烟。
报告的最常见途径是吸烟转为蒸气（74%），8 名参与者在吸烟前开始吸食蒸气，5 名参与者报告只吸食蒸气但从不吸烟。对参与者叙述的分析强调，无论起始途径如何，我们研究中的青少年通常都意识到吸烟的健康后果，并在考虑相对风险的情况下协商他们对尼古丁产品的使用。
这项研究的结果表明，ANDS 是对吸烟后果有强烈认识的青少年的一种过渡工具，因此对 ANDS 作为青少年健康威胁的传统说法提出了质疑。
这项定性研究对替代尼古丁输送系统（ANDS）有可能成为青少年和年轻人吸烟的入门工具表示关注。研究结果表明，大多数青少年参与者在他们的起始途径中讨论和考虑了相对风险，这突显了在制定有关吸烟的公共卫生信息和政策时，需要承认减少危害的必要性。
