Kjeld Simone Gad, Andersen Susan, Andersen Anette, Glenstrup Stine, Lund Lisbeth, Danielsen Dina, Bast Lotus Sofie
University of Southern Denmark, Copenhagen, Denmark.
Steno Diabetes Centre, Aarhus, Denmark.
Nordisk Alkohol Nark. 2021 Dec;38(6):555-572. doi: 10.1177/14550725211027687. Epub 2021 Aug 16.
We examined characteristics (smoking in social relations, binge drinking, and well-being measures) of Danish 13-year-olds in relation to their tobacco use patterns. Ever use of cigarettes exclusively, ever use of alternative tobacco products (ATPs; e-cigarettes, snus, or waterpipe) exclusively, and use of both cigarettes and ATPs were studied.
We used self-reported data from students at 46 Danish schools in 2017 comprising 2,307 students (response rate = 86%). Multi-level logistic regression analyses were used to examine the associations between student characteristics and the odds for having ever used any tobacco products, smoked cigarettes exclusively, used ATPs exclusively, or used both cigarettes and ATPs compared with never use of any tobacco products. Unadjusted estimates and estimates adjusted for gender were reported.
A significant minority of youth (13.2%) had used one or more tobacco products. Of these, 2.0% had exclusively smoked cigarettes, 7.2% had exclusively used ATPs, and 4.0% had used both. Findings showed that all included characteristics (families' and friends' smoking, binge drinking, and well-being characteristics) were associated with using any tobacco product; however, students with friends who smoked, had been binge drinking, and had low well-being at home had notably higher odds for having both smoked cigarettes and used ATPs compared to the other tobacco use patterns.
ATPs were popular among Danish adolescents compared with conventional cigarettes. Thus, prevention efforts among adolescents should not merely focus on the health risks of conventional cigarette smoking but also on ATPs. Students with diverse tobacco use patterns were similar on various characteristics. However, findings indicate that adolescents who had used both conventional cigarettes and ATPs constitute a more risk-averse group in special need of prevention efforts. Gender did not markedly influence the results. These findings may help future strategies aiming at the youngest adolescents at risk of using tobacco products.
我们研究了丹麦13岁青少年的特征（社交关系中的吸烟、暴饮以及幸福感指标）与他们的烟草使用模式之间的关系。研究内容包括仅曾使用香烟、仅曾使用替代烟草产品（ATPs；电子烟、鼻烟或水烟）以及同时使用香烟和ATPs的情况。
我们使用了2017年来自丹麦46所学校学生的自我报告数据，共2307名学生（回复率 = 86%）。采用多水平逻辑回归分析来研究学生特征与曾使用任何烟草产品、仅吸过香烟、仅使用过ATPs或同时使用香烟和ATPs（与从未使用任何烟草产品相比）的几率之间的关联。报告了未调整的估计值和按性别调整后的估计值。
少数青少年（13.2%）曾使用过一种或多种烟草产品。其中，2.0%仅吸过香烟，7.2%仅使用过ATPs，4.0%同时使用过两者。研究结果表明，所有纳入的特征（家人和朋友吸烟、暴饮以及幸福感特征）都与使用任何烟草产品有关；然而，与其他烟草使用模式相比，有吸烟朋友、曾暴饮且在家中幸福感较低的学生同时吸过香烟和使用过ATPs的几率明显更高。
与传统香烟相比，ATPs在丹麦青少年中更受欢迎。因此，青少年预防工作不应仅仅关注传统吸烟的健康风险，还应关注ATPs。不同烟草使用模式的学生在各种特征上相似。然而，研究结果表明，同时使用过传统香烟和ATPs的青少年构成了一个更需要预防措施的风险规避程度较高的群体。性别对结果没有显著影响。这些发现可能有助于未来针对有使用烟草产品风险的最年轻青少年制定策略。
