Division of Environmental and Preventive Medicine, Faculty of Medicine, Tottori University, Tottori 683-8503, Japan.
National Addiction Centre, Institute of Psychiatry, Psychology & Neuroscience (IoPPN), King's College London, London SE5 8BB, UK.
Int J Environ Res Public Health. 2020 Apr 30;17(9):3128. doi: 10.3390/ijerph17093128.
The impact of heated-tobacco-products (HTPs) and electronic cigarettes (e-cigarettes) on youth is a controversial public health issue, as it is unknown whether alternative products result in more youth using such products or smoking. In Japan, e-cigarettes with nicotine are prohibited, but e-cigarettes without nicotine are available. HTPs are marketed as tobacco products. Within this unique context, we aimed to compare any conventional cigarette smokers (including those who also used alternative products) with exclusive users of alternative products and examine factors relating to their use in Japan. In 2017, 22,275 students in grades 7-9 (age 12-15) and 42,142 in grades 10-12 (age 15-18) nationwide were surveyed. Overall, 1.8% were current users of any of the three products over the last month. Multivariable analysis revealed that risk factors for alternative product use were the same as those for cigarette use. Among all users, exclusive new product users were more likely to participate in club activities and intend to continue to higher education; any conventional cigarette users (including those who also used alternative products) were more likely to be exposed to secondhand smoke at home and to drink alcohol. Reducing adult smoking and disseminating health education remain relevant as strategies for preventing adolescents' future tobacco use.
加热烟草制品（HTPs）和电子烟（e-cigarettes）对青少年的影响是一个有争议的公共卫生问题，因为目前尚不清楚替代产品是否会导致更多的青少年使用这些产品或吸烟。在日本，含尼古丁的电子烟被禁止，但不含尼古丁的电子烟是可用的。HTPs 被宣传为烟草产品。在这种独特的背景下，我们旨在比较任何常规香烟吸烟者（包括那些也使用替代产品的人）与仅使用替代产品的人，并研究与他们在日本使用相关的因素。2017 年，全国有 22275 名 7-9 年级（12-15 岁）和 42142 名 10-12 年级（15-18 岁）的学生接受了调查。总体而言，1.8%的人在过去一个月内使用过这三种产品中的任何一种。多变量分析显示，替代产品使用的风险因素与香烟使用的风险因素相同。在所有使用者中，独家新产品使用者更有可能参加俱乐部活动并打算继续接受高等教育；任何常规香烟使用者（包括那些也使用替代产品的人）更有可能在家中接触二手烟，并饮酒。减少成年人吸烟和传播健康教育仍然是预防青少年未来吸烟的相关策略。
