Herbert Wertheim School of Public Health and Human Longevity Science,
Moores Cancer Center, and.
Pediatrics. 2021 Feb;147(2). doi: 10.1542/peds.2020-025122. Epub 2021 Jan 11.
To identify predictors of becoming a daily cigarette smoker over the course of 4 years.
We identified 12- to 24-year-olds at wave 1 of the US Population Assessment of Tobacco and Health Study and determined ever use, age at first use, and daily use through wave 4 for 12 tobacco products.
Sixty-two percent of 12- to 24-year-olds (95% confidence interval [CI]: 60.1% to 63.2%) tried tobacco, and 30.2% (95% CI: 28.7% to 31.6%) tried ≥5 tobacco products by wave 4. At wave 4, 12% were daily tobacco users, of whom 70% were daily cigarette smokers (95% CI: 67.4% to 73.0%); daily cigarette smoking was 20.8% in 25- to 28-year-olds (95% CI: 18.9% to 22.9%), whereas daily electronic cigarette (e-cigarette) vaping was 3.3% (95% CI: 2.4% to 4.4%). Compared with single product triers, the risk of progressing to daily cigarette smoking was 15 percentage points higher (adjusted risk difference [aRD] 15%; 95% CI: 12% to 18%) among those who tried ≥5 products. In particular, e-cigarette use increased the risk of later daily cigarette smoking by threefold (3% vs 10%; aRD 7%; 95% CI: 6% to 9%). Daily smoking was 6 percentage points lower (aRD -6%; 95% CI: -8% to -4%) for those who experimented after age 18 years.
Trying e-cigarettes and multiple other tobacco products before age 18 years is strongly associated with later daily cigarette smoking. The recent large increase in e-cigarette use will likely reverse the decline in cigarette smoking among US young adults.
确定在 4 年内成为每日吸烟者的预测因素。
我们在 US Population Assessment of Tobacco and Health Study 的第 1 波中确定了 12 至 24 岁的参与者，并通过第 4 波确定了他们的使用情况、首次使用年龄和每日使用情况，涵盖了 12 种烟草制品。
62%（95%置信区间[CI]：60.1%至63.2%）的 12 至 24 岁青少年尝试过烟草，30.2%（95%CI：28.7%至31.6%）尝试过≥5 种烟草制品。在第 4 波中，12%的人是每日烟草使用者，其中 70%（95%CI：67.4%至73.0%）是每日香烟吸烟者；25 至 28 岁的人中有 20.8%（95%CI：18.9%至22.9%）是每日电子烟使用者，而每日电子烟使用者为 3.3%（95%CI：2.4%至4.4%）。与单一产品使用者相比，尝试≥5 种产品的人发展为每日香烟吸烟者的风险高出 15 个百分点（调整后的风险差异[aRD]为 15%；95%CI：12%至 18%）。特别是，电子烟的使用使日后每日吸食香烟的风险增加了两倍（3%比 10%；aRD 7%；95%CI：6%至 9%）。对于那些在 18 岁以后开始尝试的人来说，每日吸烟的风险降低了 6 个百分点（aRD-6%；95%CI：-8%至-4%）。
在 18 岁之前尝试电子烟和其他多种烟草制品与日后吸食香烟的风险密切相关。美国年轻人中电子烟使用量的最近大幅增加可能会扭转香烟吸烟率的下降趋势。
