School of Kinesiology and Health Studies, Queen's University, Kingston, ON, Canada.
College of Osteopathic Medicine, Nova Southeastern University, Davie, FL, USA.
Nicotine Tob Res. 2022 Jun 15;24(7):978-985. doi: 10.1093/ntr/ntab248.
This study examined longitudinal associations between e-cigarette use, cigarette smoking, physical activity, and recreational screen time (ST) in a cohort of Canadian adolescents (ages 14-17 years; grades 9-12).
Data from 5951 adolescents who participated in COMPASS Year 4 (2015-2016; baseline) and Year 6 (2017-2018; follow-up) were used. Exposures included e-cigarette use and cigarette smoking. Outcomes included cutpoints for moderate- to vigorous-physical activity (MVPA; ≥60 min/d), muscular strengthening exercises (MSE; ≥3 time/wk), participation in sport (SP; intramural or competitive), and recreational screen time (ST; ≤430 min/day). Generalized linear mixed models were performed.
e-Cigarette use (16.6% vs. 39.2%), cigarette smoking (0.9% vs. 4.7%), and dual use (0.8% vs. 4.1%) increased from baseline to follow-up. SP (70.8% vs. 61.3%) and the prevalence of meeting MVPA (49.8% vs. 42.1%) and MSE cutpoints (54.0% vs. 45.3%) decreased from baseline to follow-up. Recreational ST remained similar from baseline to follow-up. New e-cigarette use at follow-up was associated with maintenance of SP and meeting MVPA and MSE cutpoints, but also with increased ST. New cigarette smoking at follow-up was associated with maintaining high ST and low SP. Cigarette smoking at baseline and follow-up was associated with maintaining high ST, low MSE, and low SP. Cigarette smoking cessation at follow-up was associated with increasing MVPA and MSE, decreasing ST, and maintaining low SP.
Given the clustering and co-occurring unhealthy behavioral patterns, intervention strategies to promote healthy lifestyles should take a holistic approach, by targeting multiple behavioral changes simultaneously.
This investigation highlighted that, unhealthy behaviors, particularly e-cigarette use, cigarette smoking, and excessive use of screens, tend to co-occur among Canadian adolescents. Therefore, intervention strategies to promote healthy lifestyles should take a holistic approach, by targeting multiple behavioral changes simultaneously particularly in school and community settings. As an exception, new and stable e-cigarette use appears to co-occur with achieving sufficient levels of physical activity. Increasing awareness about the risk of e-cigarette use may target population groups that are physically and socially active (eg, athletes, sport teams).
本研究在加拿大青少年队列（年龄 14-17 岁；9-12 年级）中研究了电子烟使用、吸烟、身体活动和娱乐性屏幕时间（ST）之间的纵向关联。
使用了 5951 名参加 COMPASS 第 4 年（2015-2016 年；基线）和第 6 年（2017-2018 年；随访）的青少年的数据。暴露因素包括电子烟使用和吸烟。结果包括中等到剧烈体力活动（MVPA；≥60 分钟/天）、肌肉强化运动（MSE；≥3 次/周）、参与运动（校内或竞技）和娱乐性屏幕时间（ST；≤430 分钟/天）的切点。进行了广义线性混合模型分析。
电子烟使用（16.6%比 39.2%）、吸烟（0.9%比 4.7%）和双重使用（0.8%比 4.1%）从基线到随访均增加。从基线到随访，SP（70.8%比 61.3%）和满足 MVPA（49.8%比 42.1%）和 MSE 切点（54.0%比 45.3%）的比例下降。从基线到随访，娱乐性 ST 保持不变。随访中新的电子烟使用与保持 SP 和满足 MVPA 和 MSE 切点相关，但也与 ST 增加有关。随访中新的吸烟与保持高 ST 和低 SP 相关。基线和随访时的吸烟与保持高 ST、低 MSE 和低 SP 相关。随访时的戒烟与增加 MVPA 和 MSE、减少 ST 和保持低 SP 相关。
鉴于聚类和同时出现的不健康行为模式，促进健康生活方式的干预策略应采取整体方法，同时针对多种行为变化。
本研究强调，不健康行为，特别是电子烟使用、吸烟和过度使用屏幕，在加拿大青少年中往往同时出现。因此，促进健康生活方式的干预策略应采取整体方法，同时针对多种行为变化，特别是在学校和社区环境中。作为一个例外，新的和稳定的电子烟使用似乎与达到足够的体力活动水平同时出现。提高对电子烟使用风险的认识可能针对身体和社交活跃的人群（例如运动员、运动队）。
