Saller Franziska S, Agaku Israel T, Filippidis Filippos T
Department of Primary Care and Public Health, School of Public Health, Imperial College London, London, UK
Department of Oral Health Policy and Epidemiology, Harvard School of Dental Medicine, Boston, Massachusetts, USA.
Tob Control. 2022 May;31(3):416-423. doi: 10.1136/tobaccocontrol-2020-055943. Epub 2021 Jan 7.
Recent years have seen a rapid increase in the popularity of electronic cigarettes (e-cigarettes) among adolescents in the USA. Evidence on their role in the continuation of or abstinence from cigarette smoking among young smokers remains scarce.
To examine the relationship between e-cigarette use initiated after cigarette smoking and abstinence from cigarette smoking among US adolescent established smokers.
The data were drawn from the 2015-2018 National Youth Tobacco Survey-a nationally representative survey of US middle and high school students. Multivariable logistic regression was used to assess the association between ever e-cigarette use and past 30-day abstinence from cigarette smoking. The analytical sample comprised ever established cigarette smokers with or without a history of e-cigarette use after smoking initiation.
Neither experimental (adjusted OR 0.67, 95% CI 0.39-1.14) nor prior established (adjusted OR 1.56, 95% CI 0.96-2.56) nor current established (adjusted OR 0.65, 95% CI 0.41-1.03) e-cigarette use was statistically significantly associated with subsequent abstinence from cigarette smoking among adolescent ever established smokers. These findings were largely consistent across sensitivity analyses using alternative key definitions, although experimental and current established e-cigarette use was significantly negatively associated with past 6-month abstinence.
We found no evidence that e-cigarette use among US adolescents already smoking cigarettes is associated with subsequent abstinence from cigarette smoking; there was some evidence of an inverse association among experimental and current established e-cigarette users. These findings could inform future regulatory and public health efforts regarding youth e-cigarette use and the reduction of youth cigarette smoking in the USA.
近年来，电子烟在美国青少年中迅速流行起来。关于电子烟在年轻吸烟者继续吸烟或戒烟方面所起作用的证据仍然很少。
研究在美国青少年成年吸烟者中，吸烟后开始使用电子烟与戒烟之间的关系。
数据来自2015 - 2018年全国青少年烟草调查——一项针对美国初中和高中学生的具有全国代表性的调查。多变量逻辑回归用于评估曾经使用电子烟与过去30天戒烟之间的关联。分析样本包括曾经开始吸烟后有或没有电子烟使用史的成年吸烟者。
无论是尝试性（调整后的比值比为0.67，95%置信区间为0.39 - 1.14）、先前已使用（调整后的比值比为1.56，95%置信区间为0.96 - 2.56）还是当前正在使用（调整后的比值比为0.65，95%置信区间为0.41 - 1.03）电子烟，在曾经成年吸烟的青少年中，与随后戒烟均无统计学显著关联。尽管使用替代关键定义进行敏感性分析时，尝试性和当前正在使用电子烟与过去6个月戒烟存在显著负相关，但这些发现总体上是一致的。
我们没有发现证据表明美国已吸烟青少年使用电子烟与随后戒烟有关；在尝试性和当前正在使用电子烟的人群中，有一些证据表明存在负相关。这些发现可为美国未来关于青少年电子烟使用监管和公共卫生工作以及减少青少年吸烟提供参考。
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