Jackson Sarah E, Beard Emma, Brown Jamie
Department of Behavioural Science and Health, University College London, London, UK.
SPECTRUM Consortium, UK.
Nicotine Tob Res. 2021 Oct 7;23(11):1831-1838. doi: 10.1093/ntr/ntab119.
This study aimed to examine how the proportion of dual users of cigarettes and e-cigarettes who use e-cigarettes in situations where smoking is not permitted has changed since e-cigarettes became popular in England, and to characterize those who do so.
Data were from 5081 adults in England who reported current smoking and current use of e-cigarettes ('dual users') participating in a nationally-representative monthly survey between April 2011 and February 2020. We modeled quarterly changes in prevalence of e-cigarette use in situations where smoking is not permitted and assessed multivariable associations with sociodemographic and smoking characteristics.
Between 2011 and 2020, prevalence of e-cigarette use in situations where smoking is not permitted followed a positive cubic trend, with a decelerating increase from an estimated 52.5% of dual users in Q2-2011 to 72.7% in Q3-2014, followed by a small decline to 67.5% in 2018, and subsequent increase to 74.0% in 2020. Odds were higher among those who were from more disadvantaged social grades, reported stronger smoking urges, or had made a past-year quit attempt, and lower among those who were aged at least 65 years (vs. 16-24 years), from the south (vs. north) of England, reported currently cutting down on their cigarette consumption or currently using nicotine replacement therapy.
In England, use of e-cigarettes in situations where smoking is not permitted is common among dual cigarette and e-cigarette users, has increased nonlinearly since 2011, and is particularly prevalent among those who are younger, disadvantaged, more addicted, have recently failed to quit, and are not attempting to cut down.
The ability to use nicotine in smoke-free settings appears to be an important part of the appeal of e-cigarettes. It is possible that if e-cigarette use was prohibited in public places, smokers may be deterred from using e-cigarettes alongside combustible tobacco, which could undermine quitting. Our results suggest disadvantaged and more addicted smokers would be disproportionately affected, suggesting such restrictions may contribute to inequalities in smoking and associated health outcomes.
本研究旨在探讨自电子烟在英国流行以来，在禁止吸烟的场所使用电子烟的卷烟和电子烟双重使用者的比例如何变化，并对这样做的人群进行特征描述。
数据来自英国5081名报告当前吸烟且当前使用电子烟的成年人（“双重使用者”），他们参与了2011年4月至2020年2月期间具有全国代表性的月度调查。我们对在禁止吸烟的场所使用电子烟的流行率的季度变化进行建模，并评估与社会人口统计学和吸烟特征的多变量关联。
2011年至2020年期间，在禁止吸烟的场所使用电子烟的流行率呈正三次趋势，从2011年第二季度估计的52.5%的双重使用者加速上升至2014年第三季度的72.7%，随后在2018年小幅下降至67.5%，并在2020年随后升至74.0%。来自社会经济地位较低阶层、报告有较强吸烟冲动或在过去一年尝试戒烟的人使用电子烟的几率较高，而年龄至少65岁（与16 - 24岁相比）、来自英格兰南部（与北部相比）、报告目前正在减少卷烟消费或目前正在使用尼古丁替代疗法的人使用电子烟的几率较低。
在英国，在禁止吸烟的场所使用电子烟在卷烟和电子烟双重使用者中很常见，自2011年以来呈非线性增加，并且在年轻人、弱势群体、成瘾性更强、最近戒烟失败且未尝试减少吸烟量的人群中尤为普遍。
在无烟环境中使用尼古丁的能力似乎是电子烟吸引力的一个重要部分。如果在公共场所禁止使用电子烟，吸烟者可能会被阻止同时使用电子烟和可燃烟草，这可能会破坏戒烟。我们的结果表明，弱势群体和成瘾性更强的吸烟者将受到不成比例的影响，这表明此类限制可能会加剧吸烟及相关健康结果方面的不平等。
