Data Science, American Cancer Society, Atlanta, Georgia.
Data Science, American Cancer Society, Atlanta, Georgia.
Am J Prev Med. 2021 Feb;60(2):151-158. doi: 10.1016/j.amepre.2020.07.026. Epub 2020 Oct 5.
The trends in e-cigarette prevalence and population count of users according to cigarette smoking histories are unknown. These data are needed to inform public health actions against a rapidly changing U.S. e-cigarette market.
Data collected between 2014 and 2018 (analyzed in 2020) from cross-sectional, nationally representative National Health Interview Surveys were used to estimate current e-cigarette prevalence, adjusted prevalence differences (percentage points), and population counts of users. Analyses were stratified by age group (younger, 18-29 years, n=25,445; middle age, 30-49 years, n=47,745; older, ≥50 years, n=79,517) and cigarette smoking histories (current smokers, recent quitters [quit <1 year ago], near-term quitters [quit 1-8 years ago], long-term quitters [quit >8 years ago], never smokers).
Among younger adults, e-cigarette use increased in all groups of smokers, with notable increases between 2014 and 2018 among never smokers (1.3%-3.3%, adjusted prevalence difference=2%, p<0.001) and near-term quitters (9.1%-19.2%, adjusted prevalence difference=8.8%, p=0.024). Conversely, the only substantial increase in e-cigarette use between 2014 and 2018 among middle-aged (5.8%-14.4%, adjusted prevalence difference=8.2%, p<0.001) and older (6.3%-9.5%, adjusted prevalence difference=3.3%, p=0.045) adults was among near-term quitters. The largest absolute population increase in e-cigarette users between 2014 and 2018 was among younger-adult never smokers (0.49-1.35 million), followed by near-term quitters among middle-aged (0.36-0.95 million), younger (0.23-0.57 million), and older (0.35-0.50 million) adults.
The continuous increase among younger-adult never smokers suggests a rise in primary nicotine initiation with e-cigarettes. The concomitant increase among near-term quitters of all age groups suggests continuing e-cigarette use among smokers who may have switched from cigarettes previously.
根据吸烟史，电子烟的流行趋势和用户人数的变化趋势尚不清楚。这些数据对于针对美国电子烟市场的快速变化采取公共卫生行动是必要的。
使用 2014 年至 2018 年（2020 年分析）期间从全国代表性的国家健康访谈调查中收集的数据，估计当前电子烟的流行率，调整后的流行率差异（百分点）以及用户人数。分析按年龄组（年轻组，18-29 岁，n=25445；中年组，30-49 岁，n=47745；老年组，≥50 岁，n=79517）和吸烟史（当前吸烟者，近期戒烟者[戒烟不到 1 年]，近期戒烟者[戒烟 1-8 年]，长期戒烟者[戒烟超过 8 年]，从不吸烟者）进行分层。
在年轻成年人中，所有吸烟组的电子烟使用率均有所增加，在从不吸烟者（1.3％-3.3％，调整后的流行率差异= 2％，p<0.001）和近期戒烟者（9.1％-19.2％，调整后的流行率差异= 8.8％，p=0.024）中，电子烟使用率在 2014 年至 2018 年间有明显增加。相反，中年（5.8％-14.4％，调整后的流行率差异= 8.2％，p<0.001）和老年（6.3％-9.5％，调整后的流行率差异= 3.3％，p=0.045）成年人中电子烟使用率唯一的大幅度增加是在近期戒烟者中。2014 年至 2018 年间，电子烟使用者的绝对人数增加最多的是年轻成年人中的从不吸烟者（0.49-1.35 百万人），其次是中年的近期戒烟者（0.36-0.95 百万人），年轻（0.23-0.57 百万人）和老年（0.35-0.50 百万人）成年人。
年轻成年人从不吸烟者的持续增加表明电子烟中尼古丁的原发性使用率有所上升。所有年龄段的近期戒烟者的同时增加表明，以前可能从香烟转为电子烟的吸烟者继续使用电子烟。
