Cerrai Sonia, Potente Roberta, Gorini Giuseppe, Gallus Silvano, Molinaro Sabrina
Epidemiology and Health Research Lab, Institute of Clinical Physiology, National Research Council of Italy (IFC-CNR), Pisa, Italy.
Occupational & Environmental Epidemiology Section, Oncologic Network, Prevention and Research Institute (ISPRO), Florence, Italy.
Int J Drug Policy. 2020 Sep 16;86:102941. doi: 10.1016/j.drugpo.2020.102941.
With increased use of electronic-nicotine delivery devices (e-cigarettes) and non-cigarettes tobacco products (heated tobacco products, shisha, moist snuff/snus) among adolescents, the percentage of Italian students who use nicotine products is at its highest level of the past ten years, even though prevention and anti-smoking policies have produced tangible results in decreasing tobacco smoking prevalence. This cross-sectional study examined trends in exclusive and dual smoking, identified new poly-consumption patterns and profiled old and new nicotine users.
We used the annual cross-sectional ESPAD® Italia survey which sampled students (aged 15-19), currently used for surveillance and monitoring of at risk population, between 2012 and 2018 (N = 170,974) to describe Italian trends in exclusive cigarette, exclusive vaping, and dual cigarette and vaping use. . For the 2018 sample, patterns of poly-consumption were described, and a multinomial logistic regression (N = 15,732) estimated characteristics associated with exclusive and dual cigarette and vaping use.
The lifetime prevalence of cigarette smokers slightly decreased from 60.9% in 2012 to 56.9% in 2018, whereas the proportion of vaping users substantially increased from 32.9% in 2013 to 52.0% in 2018. Combining cigarette and vaping use, these trends result in an increase in the lifetime prevalence of any use from 60.8% in 2013 to 66.2% in 2018. Three out of every 10 minors have experienced smoking and/or vaping, and younger students were more prone to be dual users. Overall, current vapers were generally less prone to risky behaviours.
In contrast to a slight decrease in cigarette smoking, the prevalence of Italian students approaching old and/or new smoking habits in their lifetime is substantially increasing. The popularity of alternative nicotine-based products, particularly e-cigarettes, has increased among teenagers, resulting in a summation of usage patterns rather than a compensation, and attracting a novel slice of young users. The lack of regulation within current drug policy to limit the access to such licit psychoactive substance use, is urgently needed to avoid a future nicotine addicted population.
随着青少年中电子尼古丁传送装置（电子烟）和非卷烟烟草制品（加热烟草制品、水烟、湿鼻烟/口含烟）的使用增加，尽管预防和反吸烟政策在降低吸烟流行率方面取得了切实成效，但意大利使用尼古丁产品的学生比例仍处于过去十年的最高水平。这项横断面研究调查了单纯吸烟和双重吸烟的趋势，确定了新的多种消费模式，并对新老尼古丁使用者进行了特征分析。
我们使用了2012年至2018年期间对学生（15 - 19岁）进行年度横断面抽样的ESPAD® Italia调查（N = 170,974），该调查目前用于对高危人群的监测，以描述意大利单纯吸烟、单纯吸电子烟以及同时吸烟和吸电子烟的趋势。对于2018年的样本，描述了多种消费模式，并进行了多项逻辑回归分析（N = 15,732），以估计与单纯吸烟和同时吸烟及吸电子烟相关的特征。
吸烟者的终生患病率从2012年的60.9%略有下降至2018年的56.9%，而吸电子烟者的比例则从2013年的32.9%大幅增至2018年的52.0%。综合吸烟和吸电子烟的情况，这些趋势导致任何一种使用方式的终生患病率从2013年的60.8%增至2018年的66.2%。每10名未成年人中有3人有过吸烟和/或吸电子烟经历，且年龄较小的学生更易成为双重使用者。总体而言，目前吸电子烟者一般较少有危险行为。
与吸烟率略有下降形成对比的是，意大利学生终生养成新旧吸烟习惯的患病率大幅上升。基于尼古丁的替代产品，尤其是电子烟，在青少年中的受欢迎程度有所增加，导致使用模式叠加而非相互补偿，并吸引了新一批年轻使用者。当前毒品政策缺乏对获取此类合法精神活性物质使用的限制规定，迫切需要避免未来出现尼古丁成瘾人群。
