Department of Family Medicine, UNC School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.
Division of Public Health Sciences, Department of Social Sciences and Health Policy, Wake Forest School of Medicine, Winston Salem, North Carolina.
Am J Prev Med. 2021 Jul;61(1):80-87. doi: 10.1016/j.amepre.2021.01.028. Epub 2021 Apr 11.
Studies of tobacco product warnings have focused primarily on the reach and effectiveness of cigarette warnings for adult smokers, whereas few observational studies have examined noncigarette tobacco product warnings among youth.
High school students from the 2019 National Youth Tobacco Survey (n=10,094) reported the frequency of exposure to warnings on cigar, e-cigarette, and waterpipe tobacco packages and the perceived harm of occasionally using e-cigarettes and waterpipe tobacco. In 2020, results were analyzed for the entire sample and among subgroups, including never users, ever users, youth susceptible to using tobacco, and current users.
Reported high exposure to warnings was highest for cigars (22.3%), followed by that for e-cigarettes (20.8%) and that for waterpipe tobacco (7.0%). Youth who were susceptible to using cigars (AOR=1.53, 95% CI=1.29, 1.82), who ever used cigars (AOR=4.32, 95% CI=3.57, 5.22), or who currently used cigars (AOR=8.90, 95% CI=6.95, 11.39) were more likely to report high exposure to cigar warnings than youth who never used cigars. Similar findings were observed for e-cigarette and waterpipe tobacco warnings. For youth who ever used e-cigarettes, high exposure to warnings was associated with higher odds of perceiving e-cigarettes as harmful for occasional product use (AOR=1.50, 95% CI=1.05, 2.15), and high exposure to waterpipe tobacco warnings was associated with higher odds of perceiving waterpipe tobacco as harmful (AOR=1.21, 95% CI=1.00, 1.45).
Warnings on noncigarette tobacco products reach some youth at risk for using these products, but these warnings may need to be strengthened to further reduce their use.
关于烟草制品警告的研究主要集中在香烟警告对成年吸烟者的覆盖范围和有效性上，而很少有观察性研究调查非香烟烟草制品对青少年的警告。
2019 年全国青少年烟草调查（n=10094）的高中生报告了他们在雪茄、电子烟和水烟烟草包装上看到警告的频率，以及偶尔使用电子烟和水烟烟草的感知危害。2020 年，对整个样本和包括从未使用者、曾经使用者、易受烟草使用影响的青少年和当前使用者在内的亚组进行了分析。
报告的对警告的高暴露率最高的是雪茄（22.3%），其次是电子烟（20.8%）和水烟烟草（7.0%）。易受雪茄影响的青少年（AOR=1.53，95%CI=1.29，1.82）、曾经使用过雪茄的青少年（AOR=4.32，95%CI=3.57，5.22）或当前使用雪茄的青少年（AOR=8.90，95%CI=6.95，11.39），比从未使用过雪茄的青少年更有可能报告对雪茄警告的高暴露率。对于电子烟和水烟烟草的警告，也观察到了类似的发现。对于曾经使用过电子烟的青少年来说，对警告的高暴露与偶尔使用电子烟时认为电子烟有害的几率更高（AOR=1.50，95%CI=1.05，2.15）有关，对水烟烟草警告的高暴露与认为水烟烟草有害的几率更高（AOR=1.21，95%CI=1.00，1.45）有关。
非香烟烟草制品的警告确实触及了一些有使用这些产品风险的青少年，但可能需要加强这些警告，以进一步减少它们的使用。
