Department of Sociomedical Sciences, Columbia University Mailman School of Public Health, New York, NY, USA.
Department of Sociomedical Sciences, Columbia University Mailman School of Public Health, New York, NY, USA.
Addict Behav. 2020 May;104:106263. doi: 10.1016/j.addbeh.2019.106263. Epub 2020 Jan 8.
Dual-users of cigarettes and e-cigarettes are commonly treated as a single group. Our study applied a more nuanced classification of this complex behavior to examine its associations with future tobacco use behaviors using data from Waves 1 and 3 of the Population Assessment of Tobacco and Health. Dual-users at Wave 1 (n = 1,665) were categorized into 4 groups based on the frequency with which they used each product (i.e., some days, daily). Analyses identified sociodemographic correlates of group membership and the prevalence of (1) completely switching to e-cigarettes and (2) quitting both products by Wave 3. Dual-users who smoked cigarettes every day and used e-cigarettes some days (69.6%) were the majority and more likely to have lower education (p < .001). Although some day smoking and daily e-cigarette use was the least common category (5.9%), these individuals were most likely to have completely switched to e-cigarettes by Wave 3 (aOR = 6.19, 95% CI = 3.91, 9.79). Dual-users who smoked and used e-cigarettes some days were most likely to have completely quit tobacco by Wave 3 (aOR = 3.98, 95% CI = 2.93, 5.40). In general, dual-users who had higher education or income were more likely to have completely switched to e-cigarettes or quit tobacco use by Wave 3. Adults who concurrently use cigarettes and e-cigarettes exhibit considerable heterogeneity in their use of these tobacco products. Dual-users that are higher on the socioeconomic gradient are more likely to engage in plausibly less harmful dual-use behaviors, which are more strongly associated with harm reduction and cessation behaviors. Future research should consider this variation to more accurately characterize the public health impact of dual-use.
同时使用香烟和电子烟的双重使用者通常被视为一个单一的群体。我们的研究应用了一种更细致的分类方法来研究这种复杂行为,使用来自烟草与健康人群评估的第 1 波和第 3 波的数据,来研究其与未来烟草使用行为的关联。第 1 波(n=1665)的双重使用者根据他们使用每种产品的频率(即有些日子,每天)分为 4 组。分析确定了群体成员身份的社会人口统计学相关性以及到第 3 波时(1)完全改用电子烟和(2)同时戒掉两种产品的流行率。每天吸烟和每天使用电子烟的双重使用者(69.6%)是大多数,更有可能受教育程度较低(p<0.001)。尽管每天吸烟和每天使用电子烟是最不常见的类别(5.9%),但这些人最有可能在第 3 波时完全改用电子烟(aOR=6.19,95%CI=3.91,9.79)。每天吸烟和每天使用电子烟的双重使用者最有可能在第 3 波时完全戒掉烟草(aOR=3.98,95%CI=2.93,5.40)。总的来说,教育程度或收入较高的双重使用者更有可能在第 3 波时完全改用电子烟或戒掉烟草使用。同时使用香烟和电子烟的成年人在使用这些烟草产品方面表现出相当大的异质性。在社会经济梯度上较高的双重使用者更有可能从事可能危害较小的双重使用行为,这些行为与减少危害和戒烟行为更密切相关。未来的研究应该考虑这种变化,以更准确地描述双重使用对公共健康的影响。