Seidel Ann-Kathrin, Morgenstern Matthis, Galimov Artur, Pedersen Anya, Isensee Barbara, Goecke Michaela, Hanewinkel Reiner
Institute for Therapy and Health Research, IFT-Nord, Kiel, Germany.
Department of Preventive Medicine, Institute for Health Promotion and Disease Prevention Research, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.
Nicotine Tob Res. 2022 Feb 14;24(3):366-371. doi: 10.1093/ntr/ntab166.
Experimentation with e-cigarettes is rising among youth, and there are concerns that e-cigarettes could be a new risk factor for initiating substance use. This study aimed to investigate whether e-cigarette use longitudinally predicts experimentation with cannabis.
During 2017-2019, a prospective cohort study with an observation period of 18 months was conducted with 3040 students from Germany who had never used cannabis (mean age = 14.8, range: 13-18 years). A multiple Poisson regression was used to investigate whether e-cigarette use was an independent predictor of future cannabis use.
Lifetime e-cigarette use was reported by 29.4% of the survey population (n = 894) at baseline, and 17.4% (n = 529) initiated cannabis use during the observation period. Among e-cigarette ever users, the initiation rate was 34.5% compared with 10.4% of never users. Results were robust to adjustment for age, sex, migrant status, type of school, sensation seeking, peer cannabis use, the use of alcohol and conventional cigarettes (ARR = 1.83; 95% CI: 1.48-2.25). Further analyses revealed that the association between e-cigarette use and cannabis experimentation was stronger among youth with low sensation-seeking scores (ARR = .77, CI: .61-.97) and no conventional cigarette use (ARR = .48, CI: .37-.64) at baseline.
E-cigarette use is associated with a subsequent initiation of cannabis use. This association seems to be stronger for youth who have a lower risk for substance use in general. Future studies need to investigate whether this is only true for experimental or also more frequent cannabis use.
The study indicates a prospective association between e-cigarette use and initiation of cannabis experimentation independent of other risk factors. It suggests that e-cigarette use is more strongly associated with cannabis initiation for youth with a lower propensity to use substances (low sensation-seekers and non-smokers).
青少年中电子烟的使用呈上升趋势，人们担心电子烟可能成为引发物质使用的新风险因素。本研究旨在调查电子烟的使用是否能纵向预测大麻的尝试使用情况。
在2017 - 2019年期间，对3040名来自德国且从未使用过大麻的学生（平均年龄 = 14.8岁，范围：13 - 18岁）进行了一项为期18个月的前瞻性队列研究。采用多重泊松回归来调查电子烟的使用是否是未来大麻使用的独立预测因素。
在基线时，29.4%（n = 894）的调查人群报告有过终生电子烟使用经历，17.4%（n = 529）在观察期内开始使用大麻。在曾经使用过电子烟的人群中，开始使用大麻的比率为34.5%，而从未使用过电子烟的人群中这一比率为10.4%。在对年龄、性别、移民身份、学校类型、寻求刺激、同伴大麻使用情况、酒精和传统香烟使用情况进行调整后，结果依然稳健（调整率比 = 1.83；95%置信区间：1.48 - 2.25）。进一步分析表明，在基线时寻求刺激得分较低（调整率比 = 0.77，置信区间：0.61 - 0.97）且未使用传统香烟（调整率比 = 0.48，置信区间：0.37 - 0.64）的青少年中，电子烟使用与大麻尝试使用之间的关联更强。
电子烟的使用与随后开始使用大麻有关。这种关联在一般物质使用风险较低的青少年中似乎更强。未来的研究需要调查这是否仅适用于尝试性使用大麻，还是也适用于更频繁的大麻使用情况。
该研究表明，电子烟的使用与开始尝试使用大麻之间存在前瞻性关联，且独立于其他风险因素。这表明对于物质使用倾向较低的青少年（低寻求刺激者和非吸烟者），电子烟的使用与开始使用大麻的关联更强。
