Moore Graham, Brown Rachel, Page Nicholas, Hallingberg Britt, Maynard Olivia, McKell Jennifer, Gray Linsay, Blackwell Anna, Lowthian Emily, Munafò Marcus, Mackintosh Anne-Marie, Bauld Linda
Centre for the Development and Evaluation of Complex Interventions for Public Health Improvement, Cardiff University; SPECTRUM Consortium, UK.
Centre for the Development and Evaluation of Complex Interventions for Public Health Improvement, Cardiff University.
Int J Drug Policy. 2020 Nov;85:102795. doi: 10.1016/j.drugpo.2020.102795. Epub 2020 Aug 24.
Young people's experimentation with e-cigarettes has increased in recent years, although regular use remains limited. EU Tobacco Products Directive (TPD) regulations introduced packet warnings, advertising restrictions, and regulated nicotine strength from 2016, in part due to concerns regarding use by young people. This paper examines e-cigarette use trajectories before and after TPD.
E-cigarette use data were obtained from School Health Research Network/Health Behaviour in School-aged Children surveys in Wales and Smoking Drinking and Drug Use surveys in England. Data from Wales were analysed using segmented logistic regression, with before and after regression analyses of English data. Semi-structured group interviews included young people aged 14-16 years in Wales, England and Scotland in 2017 and 2018.
In Wales, ever use of e-cigarettes increased over time, but under a range of assumptions, growth did not appear to continue post-TPD. A small and non-significant change in trend was observed post-implementation (OR=0.96; 95%CI=0.91 to 1.01), which increased in size and significance after adjusting for ever smoking (OR=0.93; 95%CI=0.88 to 0.98). There was little increase in regular e-cigarette use from 2015 to 2017 in Wales. However, ever and regular use increased from 2014 to 2016 in England. Young people in all nations described limited interactions with components of TPD, while describing e-cigarette use as a 'fad', which had begun to run its course.
This study provides preliminary evidence that young people's e-cigarette experimentation may be plateauing in UK nations. The extent to which this arises from regulatory changes, or due to a fad having begun to lose its appeal among young people in the UK countries, remains unclear. These trends contrast to those observed in North America, where newer products whose EU market entry and marketing have been impacted by TPD, have gained traction among young people. Long-term monitoring of e-cigarette use trends and perceptions among young people remain vital.
近年来，年轻人尝试电子烟的情况有所增加，不过经常使用的情况仍然有限。欧盟烟草产品指令（TPD）法规自2016年起引入了烟包警告、广告限制并对尼古丁含量进行了规定，部分原因是出于对年轻人使用电子烟的担忧。本文研究了TPD实施前后电子烟的使用轨迹。
电子烟使用数据来自威尔士的学校健康研究网络/学龄儿童健康行为调查以及英格兰的吸烟、饮酒和吸毒调查。威尔士的数据使用分段逻辑回归进行分析，对英格兰的数据进行前后回归分析。半结构化小组访谈包括2017年和2018年在威尔士、英格兰和苏格兰的14至16岁年轻人。
在威尔士，曾经使用电子烟的情况随时间增加，但在一系列假设下，TPD实施后增长似乎并未持续。实施后观察到趋势有微小且不显著的变化（比值比=0.96；95%置信区间=0.91至1.01），在调整曾经吸烟情况后，变化幅度和显著性增加（比值比=0.93；95%置信区间=0.88至0.98）。2015年至2017年威尔士经常使用电子烟的情况几乎没有增加。然而，2014年至2016年英格兰曾经使用和经常使用电子烟的情况有所增加。所有国家的年轻人都表示与TPD的各项内容互动有限，同时将电子烟使用描述为一种“时尚”，且这种时尚已开始逐渐消退。
本研究提供了初步证据，表明英国各地区年轻人尝试电子烟的情况可能趋于平稳。这在多大程度上是由于监管变化，或者是由于这种时尚在英国年轻人中开始失去吸引力，目前尚不清楚。这些趋势与北美观察到的情况形成对比，在北美，那些欧盟市场准入和营销受到TPD影响的新产品在年轻人中获得了青睐。对年轻人电子烟使用趋势和认知的长期监测仍然至关重要。
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