Department of Kinesiology, California State University, Stanislaus, One University Circle, Turlock, CA 95382, USA.
Department of Health and Kinesiology, Texas A&M University, 2929 Research Parkway, College Station, TX 77843, USA.
Prev Med. 2021 Apr;145:106429. doi: 10.1016/j.ypmed.2021.106429. Epub 2021 Jan 19.
The use of electronic cigarettes (e-cigarettes) and marijuana remain prevalent problems among adolescents nationwide. We assessed current (past 30-day) exclusive e-cigarette use, exclusive marijuana use, and concurrent use with unintentional injury and violent behaviors, alcohol and other drug use behaviors, and sexual behaviors among U.S. high school students. We analyzed 2017 Youth Risk Behavior Survey data including 12,578 high school students nationwide. Multivariable logistic regression models were performed to compare these health-risk behaviors among exclusive e-cigarette users, exclusive marijuana users, and concurrent users with non-users among the overall sample, and then to compare exclusive e-cigarette users and exclusive marijuana users with concurrent users among current users only. All models adjusted for adolescent sex, grade, and race/ethnicity, and other tobacco product use. Approximately 77% of students were non-users, 5.2% were exclusive e-cigarette users, 9.9% were exclusive marijuana users, and 7.8% were concurrent users. Compared to non-users, exclusive e-cigarette users and exclusive marijuana users were more likely to engage in most negative health-risk behaviors associated with unintentional injuries and violence, alcohol and other drug use, and sexual behaviors. Among current users only, exclusive e-cigarette users and exclusive marijuana users were at reduced odds of engaging in most of these health-risk behaviors when compared to concurrent users of both substances. The relationship between exclusive and concurrent e-cigarette and marijuana use and health-risk behaviors highlights the importance of comprehensive educational efforts during high school. Findings suggest need for more studies on influence of e-cigarette and marijuana use on injury and violence risk among youth.
电子烟（e-cigarettes）和大麻的使用在全国青少年中仍然是普遍存在的问题。我们评估了美国高中生目前（过去 30 天内）是否有单独使用电子烟、单独使用大麻以及同时使用电子烟和大麻与非故意伤害和暴力行为、酒精和其他药物使用行为以及性行为的情况。我们分析了包括全国范围内 12578 名高中生的 2017 年青少年风险行为调查数据。采用多变量逻辑回归模型比较了在总体样本中，单独使用电子烟、单独使用大麻和同时使用电子烟和大麻的青少年与非使用者之间的这些健康风险行为，然后在当前使用者中比较了单独使用电子烟和单独使用大麻的青少年与同时使用电子烟和大麻的青少年之间的差异。所有模型都调整了青少年的性别、年级和种族/民族，以及其他烟草制品的使用情况。大约 77%的学生是非使用者，5.2%是单独使用电子烟的用户，9.9%是单独使用大麻的用户，7.8%是同时使用者。与非使用者相比，单独使用电子烟和单独使用大麻的青少年更有可能参与与非故意伤害和暴力、酒精和其他药物使用以及性行为相关的大多数负面健康风险行为。仅在当前使用者中，与同时使用两种物质的青少年相比，单独使用电子烟和单独使用大麻的青少年更有可能减少参与大多数这些健康风险行为的几率。单独和同时使用电子烟和大麻与健康风险行为之间的关系突出了在高中阶段进行全面教育的重要性。研究结果表明，需要进一步研究电子烟和大麻使用对青少年伤害和暴力风险的影响。
