Copp Sebastian R, Wilson Maria N, Asbridge Mark
Department of Post-Graduate Medicine, Dalhousie University Faculty of Medicine, Medicine, Halifax, Nova Scotia, Canada.
Department of Community Health and Epidemiology, Dalhousie University, Halifax, Nova Scotia, Canada.
Subst Use Misuse. 2022;57(7):1022-1034. doi: 10.1080/10826084.2022.2058702. Epub 2022 Apr 9.
E-cigarette use is increasing among Canadian youth, with experimentation especially prevalent among never-smoking youth. Among this group, there is concern e-cigarette use contributes to future initiation of smoking through a gateway effect. However, e-cigarette use and smoking share many common risk factors; a postulated mechanism to explain the apparent causal pathway from e-cigarette use to smoking initiation in previously smoking-naïve youth. A better understanding of the relationships between smoking susceptibility and e-cigarette use among never-smoking youth is needed. The primary aim of this study was to gain a deeper understanding of the risk factors associated with smoking susceptibility in youth who have recently used e-cigarettes. Methods: This study used data ( = 40,363) from the 2018/2019 Canadian Student Tobacco Alcohol and Drug Use Survey (CSTADS) to compare the risk factor profiles of susceptible and non-susceptible never-smoking e-cigarette users, as well as susceptible and non-susceptible never-smoking youth who have never used an e-cigarette. E-cigarette use, independent of susceptibility status, was associated with a sociodemographic and behavioral risk factor profile likely to confer a higher risk of initiating smoking. Among e-cigarette users, smoking susceptibility was associated with more smoking risk factors. Study findings support a common risk-factor model, rather than e-cigarette use itself, to explain differences in the likelihood of smoking initiation among e-cigarette users. E-cigarette use and smoking initiation may be interchangeable outcomes amongst those with smoking risk factors. The risks of e-cigarette use, and their regulatory status, need to be balanced with their potential as harm reduction tools.
在加拿大青少年中，电子烟的使用正在增加，尤其是在从不吸烟的青少年中，尝试使用电子烟的情况尤为普遍。在这一群体中，人们担心电子烟的使用会通过一种诱导效应导致未来开始吸烟。然而，电子烟的使用和吸烟有许多共同的风险因素；这是一种假设的机制，用于解释在以前从未吸烟的青少年中，从使用电子烟到开始吸烟的明显因果途径。需要更好地了解从不吸烟的青少年中吸烟易感性与电子烟使用之间的关系。本研究的主要目的是更深入地了解近期使用电子烟的青少年中与吸烟易感性相关的风险因素。方法：本研究使用了2018/2019年加拿大学生烟草、酒精和药物使用调查（CSTADS）的数据（n = 40363），以比较易患和不易患的从不吸烟的电子烟使用者，以及从未使用过电子烟的易患和不易患的从不吸烟的青少年的风险因素概况。无论易感性状态如何，电子烟的使用都与可能导致更高吸烟起始风险的社会人口学和行为风险因素概况相关。在电子烟使用者中，吸烟易感性与更多的吸烟风险因素相关。研究结果支持一种共同风险因素模型，而非电子烟使用本身，来解释电子烟使用者中开始吸烟可能性的差异。在有吸烟风险因素的人群中，电子烟的使用和开始吸烟可能是可互换的结果。电子烟使用的风险及其监管状况，需要与其作为减少危害工具的潜力相平衡。
