Department of Epidemiology, Robert Stempel College of Public Health and Social Work, Florida International University, 11200 SW 8th Street, AHC5, Miami, FL, 33199, USA.
School of Public Health, University of Sydney, Sydney, 2006, Australia.
J Prev (2022). 2022 Jun;43(3):387-405. doi: 10.1007/s10935-022-00678-z. Epub 2022 May 5.
Currently, the debate surrounding the regulation of e-cigarettes focuses mainly on the size of e-cigarettes' potentially beneficial effects (i.e., adult cessation) versus their unwarranted effects (i.e., initiation among tobacco-naïve adolescents). Therefore, we investigated the relative scale of e-cigarette use transitions in the United States. We reported cross-sectional weighted prevalence estimates of past-month e-cigarette use by ever cigarette use from Waves 1-4 of the Population Assessment of Tobacco and Health study (2013-2018) among youth (12-17 years) and adults (≥ 18 years). We also examined past-month e-cigarette mono and dual transitions related to cigarette smoking and reported the longitudinal weighted prevalence across waves. Among youth new e-cigarette users, the proportion of never-cigarette smokers increased from 24.1 in Wave 1 (n = 418) to 51.4% in Wave 4 (n = 310) (p < 0.0001 for trend). Of youth past-month e-cigarette mono-users in Wave 1 (n = 151), 15.2% transitioned to cigarette mono-use and 8.2% dual-use at Wave 2 or 3 or 4, compared to 60.2% no tobacco use and 16.4% e-cigarette mono-use. Among young adult past-month dual-users (18-24 years; n = 684), 22.6% transitioned to no tobacco use, 60.1% continued cigarette use, 11.4% dual use, and 5.9% e-cigarette mono-use. Among adult dual-users ≥ 25 years old (n = 1560), 13.6% transitioned to no tobacco use, 71.3% cigarette mono-use, 9.0% dual-use, and 6.1% e-cigarette mono-use. Transition to cigarette mono-use and continued dual-use were common among adult past-month e-cigarette users, while e-cigarette initiation was common among youth never-cigarette smokers. These findings contrast with data from other countries showing limited evidence of e-cigarette initiation among youth never cigarette smokers. Both e-cigarette and cigarette use should be addressed in youth and adults, given the potential for dual use in both populations.
目前,围绕电子烟监管的争论主要集中在电子烟潜在有益效果(即成人戒烟)与不必要效果(即诱导烟草初吸青少年使用)的相对规模上。因此,我们调查了美国电子烟使用的转变相对规模。我们报告了 2013 年至 2018 年人群烟草与健康评估研究(Population Assessment of Tobacco and Health study,PATH)第 1 波至第 4 波中青少年(12-17 岁)和成年人(≥18 岁)中曾使用香烟者的过去一个月电子烟使用的横断面加权流行率估计值。我们还研究了与吸烟相关的过去一个月电子烟单用和双用的转变,并报告了整个波次的纵向加权流行率。在新使用电子烟的青少年中,从不吸烟的青少年比例从第 1 波的 24.1%(n=418)增加到第 4 波的 51.4%(n=310)(p<0.0001,趋势有统计学意义)。在第 1 波中,过去一个月使用电子烟的青少年单用户(n=151)中,15.2%的人在第 2 波或第 3 波或第 4 波转为吸烟单用户,8.2%的人转为同时使用香烟和电子烟,而 60.2%的人没有使用烟草,16.4%的人只使用电子烟。在过去一个月使用电子烟的年轻成年双用户(18-24 岁;n=684)中,22.6%的人转为不使用任何烟草,60.1%的人继续使用香烟,11.4%的人同时使用香烟和电子烟,5.9%的人只使用电子烟。在≥25 岁的成年双用户中(n=1560),13.6%的人转为不使用任何烟草,71.3%的人只使用香烟,9.0%的人同时使用香烟和电子烟,6.1%的人只使用电子烟。在成年过去一个月使用电子烟的人群中,转为吸烟单用户和继续使用双用户较为常见,而在青少年从不吸烟者中,电子烟的使用呈上升趋势。这些发现与其他国家的数据形成对比,其他国家的数据显示,青少年从不吸烟者使用电子烟的证据有限。鉴于在这两个群体中都存在双重使用的可能性,应同时解决电子烟和香烟的使用问题。