Yale University School of Public Health, New Haven, 60 College St, New Haven, CT, 06510, USA.
Department of Epidemiology, University of Michigan, Ann Arbor, MI, USA.
Addiction. 2021 Sep;116(9):2486-2497. doi: 10.1111/add.15439. Epub 2021 Feb 21.
Reports of youth e-cigarette use often do not disaggregate by underlying smoking status. This study compared annual 2014-19 youth estimates of past 30-day e-cigarette use prevalence and frequency by smoking status in the United States.
Nationally representative, cross-sectional, school-based survey [National Youth Tobacco Surveys (NYTS)]. General linear models accounting for complex survey design compared e-cigarette use prevalence by smoking status by year, overall and stratified by frequency, separately for high school (HS) and middle school (MS) students. The 2019 survey was analyzed separately because of its change in survey methodology.
MSs and HSs in the United States.
A total of 116 704 students from 1268 schools, ages 9-19.
Students self-reported (paper 2014-18, electronic 2019) ever and past 30-day (current) use of e-cigarettes and cigarettes, as well as frequent use (20-30 days of month).
From 2014 to 2018, current e-cigarette use prevalence increased among never, current and former smokers in HS, but only among never and current smokers in MS (each P-value < 0.001). E-cigarette use increases for current HS smokers were primarily among frequent e-cigarette users. In 2018, the absolute number of HS frequent users who were never or former smokers (420 000 combined) surpassed current smokers (370 000). In 2019, current e-cigarette use prevalence for never, former and current smokers was 17.5% [95% confidence interval (CI) = 16.0-19.0], 53.6% (95% CI = 45.2-61.9) and 85.8% (95% CI = 81.6-89.9) for HS students, respectively, and 6.8% (95% CI = 5.9-7.7), 40.8% (95% CI = 34.7-47.0) and 78.0% (95% CI = 71.9-84.2) for MS students. That year, the number of HS never (420 000) and former smokers (570 000) using e-cigarettes frequently eclipsed that of current smokers (390 000).
E-cigarette use prevalence and frequency among youth vary by smoking status, with highest levels of use among current smokers. However frequent e-cigarette use among never smokers and former smokers has increased.
青少年吸电子烟的报告通常不按潜在吸烟状况进行细分。本研究比较了美国青少年在过去 30 天内使用电子烟的年度 2014-19 年估计患病率和频率，按吸烟状况进行细分。
全国代表性的、横断面的、基于学校的调查[全国青少年烟草调查（NYTS）]。考虑到复杂调查设计的一般线性模型，按吸烟状况、按年比较电子烟使用的患病率，总体上和按频率分层，分别针对高中生（HS）和初中生（MS）。2019 年的调查是分开分析的，因为它改变了调查方法。
美国的初中和高中。
共 116704 名来自 1268 所学校的 9-19 岁学生。
学生自我报告（2014-18 年纸质问卷，2019 年电子问卷）曾经和过去 30 天（当前）使用电子烟和香烟，以及频繁使用（每月 20-30 天）。
从 2014 年到 2018 年，高中生中从未、当前和以前吸烟者的当前电子烟使用比例增加，但初中生中只有从未和当前吸烟者增加（每个 P 值均<0.001）。当前高中生吸烟者电子烟使用率的增加主要是在频繁使用者中。2018 年，从未吸烟者或以前吸烟者（合计 42 万人）中经常使用电子烟的人数超过了当前吸烟者（37 万人）。2019 年，从未、以前和当前吸烟者的当前电子烟使用率分别为 HS 学生的 17.5%[95%置信区间（CI）=16.0-19.0]、53.6%（95% CI=45.2-61.9）和 85.8%（95% CI=81.6-89.9），MS 学生的分别为 6.8%（95% CI=5.9-7.7）、40.8%（95% CI=34.7-47.0）和 78.0%（95% CI=71.9-84.2）。那一年，HS 中经常使用电子烟的从未吸烟者（42 万人）和以前吸烟者（57 万人）的数量超过了当前吸烟者（39 万人）。
青少年电子烟使用率和频率因吸烟状况而异，当前吸烟者的使用率最高。然而，从未吸烟者和以前吸烟者的电子烟使用频率有所增加。
