Department of Health Behavior, Society and Policy, Rutgers School of Public Health, Piscataway, New Jersey.
Rutgers Center for Tobacco Studies, New Brunswick, New Jersey.
JAMA Netw Open. 2020 Feb 5;3(2):e1920961. doi: 10.1001/jamanetworkopen.2019.20961.
Use of electronic cigarettes (e-cigarettes) is high among adolescents, but the extent to which the JUUL e-cigarette brand accounts for the high prevalence has not been explored using population-based surveys.
To examine e-cigarette and JUUL use among adolescents in New Jersey.
DESIGN, SETTING, AND PARTICIPANTS: Survey study using data from the 2018 New Jersey Youth Tobacco Survey, a cross-sectional statewide representative survey of tobacco use. The survey was school based and sampled New Jersey students in grades 9 to 12.
Use of tobacco products; JUUL as first tobacco product tried; exposure to JUUL at school; number of friends perceived as JUUL users; liking or following a tobacco brand on social media; and buying or receiving tobacco-branded merchandise.
Prevalence ratio (PR) for current and frequent e-cigarette use, inclusive of JUUL.
In this sample of 4183 adolescents, respondents were 49.6% female and 49.6% non-Hispanic white. Students were evenly distributed across grades 9 through 12. Overall, the estimate for current use of e-cigarettes inclusive of JUUL was higher (24.2%; 95% CI, 22.5%-25.9%) compared with current use assessed by use of e-cigarettes only (17.8%; 95% CI, 16.4%-19.4%) or JUUL use only (21.3%; 95% CI, 19.7%-23.0%). Divergence in e-cigarette use estimates was higher for certain subgroups, including female respondents and non-Hispanic black respondents. Also, 88.8% (95% CI, 86.6%-91.1%) of current e-cigarette users reported JUUL as a brand they used. Hispanic students (PR, 0.78; 95% CI, 0.69-0.89) and non-Hispanic students of other races (PR, 0.64; 95% CI, 0.51-0.81) were significantly less likely than non-Hispanic white students to be current e-cigarette users, and students in 12th grade were more likely than those in 9th grade to be current users (PR, 1.29; 95% CI, 1.11-1.48). Current e-cigarette use was positively associated with current use of other tobacco products (PR, 2.57; 95% CI, 2.24-2.95), endorsing a tobacco brand on social media (PR, 1.43; 95% CI, 1.19-1.72), having tobacco-branded merchandise (PR, 1.70; 95% CI, 1.46-1.97), having close friends who used JUUL (PR, 3.81; 95% CI, 3.17-4.58), and seeing JUUL used on school grounds (PR, 1.43; 95% CI, 1.24-1.65). Estimates of prevalence were greater when modeling frequent use.
This study found that prevalence of current and frequent e-cigarette use among adolescents was higher when inclusive of JUUL use, and JUUL was by far the most common e-cigarette brand used, providing support for inclusion of brand-specific questions when assessing e-cigarette use. The results also identify characteristics of adolescents who may be more likely to use e-cigarettes.
青少年使用电子烟（电子烟）的比例很高，但使用 JUUL 电子烟品牌在多大程度上导致了这种高流行率，还没有通过基于人群的调查来探索。
检查新泽西州青少年使用电子烟和 JUUL 的情况。
设计、设置和参与者：使用 2018 年新泽西州青少年烟草调查的数据进行调查研究，这是一项全州范围内具有代表性的青少年烟草使用横断面调查。该调查以学校为基础，抽样了 9 至 12 年级的新泽西州学生。
使用烟草产品；JUUL 作为尝试的第一种烟草产品；在学校接触 JUUL；感知到的喜欢或关注烟草品牌的朋友数量；在社交媒体上购买或收到烟草品牌商品。
当前和频繁使用电子烟的流行率比（PR），包括 JUUL。
在这个 4183 名青少年的样本中，受访者 49.6%为女性，49.6%为非西班牙裔白人。学生在 9 到 12 年级之间均匀分布。总的来说，包括 JUUL 在内的当前电子烟使用率（24.2%；95%CI，22.5%-25.9%）高于仅评估使用电子烟（17.8%；95%CI，16.4%-19.4%）或仅 JUUL 使用率（21.3%；95%CI，19.7%-23.0%）的估计值。在某些亚组中，电子烟使用估计值的差异更大，包括女性受访者和非西班牙裔黑人受访者。此外，88.8%（95%CI，86.6%-91.1%）的当前电子烟使用者报告 JUUL 是他们使用的品牌。西班牙裔学生（PR，0.78；95%CI，0.69-0.89）和其他种族的非西班牙裔学生（PR，0.64；95%CI，0.51-0.81）与非西班牙裔白人学生相比，使用电子烟的可能性显著降低，而 12 年级的学生比 9 年级的学生更有可能成为当前的使用者（PR，1.29；95%CI，1.11-1.48）。当前电子烟的使用与当前使用其他烟草产品（PR，2.57；95%CI，2.24-2.95）、在社交媒体上认可一个烟草品牌（PR，1.43；95%CI，1.19-1.72）、拥有烟草品牌的商品（PR，1.70；95%CI，1.46-1.97）、有喜欢 JUUL 的亲密朋友（PR，3.81；95%CI，3.17-4.58）以及在学校看到 JUUL 被使用（PR，1.43；95%CI，1.24-1.65）显著相关。在对频繁使用进行建模时，估计的流行率更高。
这项研究发现，当包括 JUUL 的使用时，青少年当前和频繁使用电子烟的比例更高，而 JUUL 是迄今为止最常见的电子烟品牌，这支持在评估电子烟使用情况时纳入品牌特定问题。研究结果还确定了可能更有可能使用电子烟的青少年的特征。
