Social Development Research Group, School of Social Work, University of Washington, Seattle, WA, USA.
Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, USA.
Addiction. 2021 May;116(5):1224-1232. doi: 10.1111/add.15317. Epub 2021 Feb 3.
There is a public health concern that the use of e-cigarettes among non-smoking young adults could be associated with transition to combustible cigarette use. The current study is a quasi-experimental test of the relationship between e-cigarette use and subsequent combustible cigarette use among young adult non-smokers, accounting for a wide range of common risk factors.
Logistic regression was used to predict combustible cigarette use on three or more occasions at age 23 years based on age 21 e-cigarette use. Inverse probability weighting (IPW) was used to account for confounding variables.
Data were drawn from the Community Youth Development Study (CYDS), a cohort study of youth recruited in 2003 in 24 rural communities in seven US. states PARTICIPANTS: Youth in the CYDS study (n = 4407) were surveyed annually from ages 11 to 16, and at ages 18, 19, 21 and 23 years (in 2016). The sample was gender balanced (50% female) and ethnically diverse (20% Hispanic, 64% white, 3% black and 12% other race or ethnicity). The current study was limited to participants who had never used combustible cigarettes by age 21 (n = 1825).
Age 21 use of e-cigarettes and age 23 use of combustible cigarettes (three or more occasions) were included in the regression analysis. Age 11-19 measures of 22 common predictors of both e-cigarette and combustible cigarette use (e.g. pro-cigarette attitudes, peer smoking, family monitoring) were used to create IPWs.
After applying IPW, e-cigarette use at age 21 was associated with a twofold increase in odds of combustible cigarette use on three or more occasions 2 years later (odds ratio = 2.16, confidence interval 1.23, 3.79).
Among previously never-smoking US young adults, e-cigarette use appears to be strongly associated with subsequent combustible cigarette smoking, over and above measured preexisting risk factors.
公众健康担忧的是，使用电子烟在非吸烟的年轻成年人中可能与过渡到可燃香烟使用有关。目前的研究是对电子烟使用与年轻成年非吸烟者随后可燃香烟使用之间关系的准实验测试，考虑到广泛的常见风险因素。
使用逻辑回归来预测 23 岁时三次或更多次使用可燃香烟，基于 21 岁时使用电子烟。逆概率加权（IPW）用于解释混杂变量。
数据来自社区青年发展研究（CYDS），这是一项在美国七个州的 24 个农村社区招募的青年队列研究。
CYDS 研究中的青年（n=4407）从 11 岁到 16 岁每年接受调查，并在 18、19、21 和 23 岁（2016 年）接受调查。样本在性别上平衡（50%为女性），种族多样化（20%为西班牙裔，64%为白人，3%为黑人，12%为其他种族或族裔）。本研究仅限于 21 岁时从未使用过可燃香烟的参与者（n=1825）。
21 岁时使用电子烟和 23 岁时使用可燃香烟（三次或更多次）被纳入回归分析。11-19 岁时使用的 22 个常见电子烟和可燃香烟使用预测因素的测量值（例如，亲香烟态度、同伴吸烟、家庭监测）用于创建 IPW。
在应用 IPW 后，21 岁时使用电子烟与两年后三次或更多次可燃香烟使用的几率增加两倍相关（比值比=2.16，置信区间 1.23，3.79）。
在美国从未吸烟的年轻成年人中，电子烟的使用似乎与随后的可燃香烟吸烟密切相关，超过了已测量的既定风险因素。
