Center for the Study of Drugs, Alcohol, Smoking and Health, School of Nursing, University of Michigan, Ann Arbor, Michigan; Institute for Research on Women and Gender, University of Michigan, Ann Arbor, Michigan; Institute for Social Research, University of Michigan, Ann Arbor, Michigan; Center for Human Growth and Development, University of Michigan, Ann Arbor, Michigan.
Center for the Study of Drugs, Alcohol, Smoking and Health, School of Nursing, University of Michigan, Ann Arbor, Michigan; Institute for Research on Women and Gender, University of Michigan, Ann Arbor, Michigan; Center for Human Growth and Development, University of Michigan, Ann Arbor, Michigan; Department of Psychiatry, Addiction Center, University of Michigan, Ann Arbor, Michigan.
J Adolesc Health. 2020 Oct;67(4):531-541. doi: 10.1016/j.jadohealth.2020.03.032. Epub 2020 May 10.
The aim of this study was to examine the school-level prevalence and predictors of e-cigarette use among U.S. adolescents.
The Monitoring the Future study is an annual national cross-sectional study of secondary (middle and high) school students. This study uses 2015 and 2016 survey data from 8th, 10th, and 12th grade students (n = 38,926) attending 580 U.S. public and private secondary schools. E-cigarette use, binge drinking, cigarette smoking, marijuana use, and nonmedical prescription drug use were measured at the individual level. School-level characteristics were measured with both aggregated student-level measures (e.g., school-level e-cigarette use, school-level racial composition) and school characteristics (e.g., public vs. private, urban vs. rural).
The prevalence of past-month e-cigarette use varied considerably across 580 U.S. middle and high schools, ranging from 0% to 60% at individual schools (mean = 10.2%, standard deviation = 8.9%). Multivariable regression analyses indicated that past-month e-cigarette use was significantly higher at schools with a higher proportion of White students, schools that were located in the U.S. Southern and Western regions, and schools with higher prevalence of past-month cigarette smoking, after controlling for relevant individual- and school-level covariates.
E-cigarette use varies considerably across schools, and this study suggests that school context plays an important role in e-cigarette use. Cigarette smoking and e-cigarette use at the school level are closely linked and are important risk factors for individual-level e-cigarette use. The wide variation in prevalence of e-cigarette use highlights the need for schools to work with professionals to obtain school-level assessment rather than relying solely on state or national results to guide prevention efforts.
本研究旨在调查美国青少年中电子烟的使用情况及其在学校层面的流行率和预测因素。
“监测未来”研究是一项针对中学生（初中和高中）的年度全国横断面研究。本研究使用了 2015 年和 2016 年 8 年级、10 年级和 12 年级学生（n=38926）的数据，这些学生就读于美国 580 所公立和私立中学。电子烟使用、狂饮、吸烟、大麻使用和非医疗处方药物使用是在个体层面上进行测量的。学校层面的特征是通过聚合的学生层面指标（例如，学校层面的电子烟使用情况、学校层面的种族构成）和学校特征（例如，公立与私立、城市与农村）来衡量的。
580 所美国中学电子烟的过去一个月使用率差异很大，从个别学校的 0%到 60%不等（平均值为 10.2%，标准差为 8.9%）。多变量回归分析表明，在白人学生比例较高、位于美国南部和西部地区、过去一个月吸烟率较高的学校，电子烟的过去一个月使用率显著较高，在控制了相关个体和学校层面的协变量后。
电子烟的使用在学校之间差异很大，本研究表明学校环境在电子烟使用中起着重要作用。学校层面的吸烟和电子烟使用密切相关，是个体层面电子烟使用的重要危险因素。电子烟使用率的广泛差异突出表明，学校需要与专业人员合作，进行学校层面的评估，而不是仅仅依赖州或国家的结果来指导预防工作。
