National Research Council, Institute of Clinical Physiology, Pisa, Italy.
Oncologic Network, Prevention and Research Institute (ISPRO), Florence, Italy.
Addiction. 2022 Nov;117(11):2918-2932. doi: 10.1111/add.15982. Epub 2022 Jul 12.
Representative data on e-cigarette use among European adolescents are scant. This study reports current vaping and tobacco smoking individual and country-specific correlates among European students.
Cross-sectional survey: 2019 European School Survey Project on Alcohol and Other Drugs (ESPAD) collecting data on risk behaviours on a representative sample of 16-year-old students.
A total of 35 European countries, 25-30 with Tobacco Control Scale (TCS) and TCS components PARTICIPANTS: A total of 99 648 students (49.1% males) turning 16 years in the survey year.
Data on current cigarette and e-cigarette use were gathered through a self-administered questionnaire which also collected socio-demographics and individual and family characteristics. ESPAD data were integrated with country-level data on TCS and selected TCS parameters to assess their association with the prevalence of current cigarette and e-cigarette use.
Of the 99 648 participating students, 12.4% were current e-cigarette users, from 5.5% in Serbia to 41.4% in Monaco; 19.3% current smokers, from 5.1% in Iceland to 32.4% in Italy. Compared with non-users, current e-cigarette users less frequently came from an average well-off family [odds ratio (OR) = 0.85, 95% confidence interval (CI) = 0.80-0.90] and lived in countries with higher cigarette prices (OR = 0.71, 95% CI = 0.50-0.99), restrictive measures on tobacco advertising and promotion (OR = 0.79, 95% CI = 0.63-0.99) and intermediate implementation of tobacco control measures (OR = 0.57, 95% CI = 0.38-0.85). Current vapers were more frequently life ever smokers (OR = 7.31, 95% CI = 6.47-8.25), were early smokers (OR = 4.35, 95% CI = 3.66-5.17), males (OR = 1.61, 95% CI = 1.55-1.67), from non-traditional families (OR = 1.43, 95% CI = 1.34-1.53), with relatively low parental education (OR = 1.15, 95% CI = 1.10-1.20). Compared with non-smokers, current smokers had similar family characteristics to vapers, and were less likely to live in countries with higher cigarette prices (OR = 0.70, 95% CI = 0.49-0.99) and higher spending on public anti-tobacco media campaigns (OR = 0.23, 95% CI = 0.10-0.50).
E-cigarette use among European adolescents is associated with weaker tobacco control measures, particularly on tobacco price, advertising and promotion. Besides preventing tobacco smoking, the adoption of governmental tobacco control policies in European countries also seems to contribute to the prevention of vaping among adolescents.
目前，欧洲青少年使用电子烟的数据非常有限。本研究报告了欧洲学生中当前电子烟使用和个体及国家特有的相关因素。
横断面调查：2019 年欧洲学校酒精和其他药物调查项目（ESPAD），在代表 16 岁学生的样本中收集风险行为数据。
共有 35 个欧洲国家，其中 25-30 个国家具有烟草控制量表（TCS）和 TCS 成分。
共有 99648 名学生（49.1%为男性），在调查年份年满 16 岁。
通过自我管理问卷收集当前吸烟和电子烟使用的数据，该问卷还收集了社会人口统计学、个体和家庭特征。ESPAD 数据与国家层面的 TCS 数据和选定的 TCS 参数进行了整合，以评估它们与当前吸烟和电子烟使用的流行率之间的关系。
在 99648 名参与学生中，有 12.4%的学生是当前的电子烟使用者，比例最低的是塞尔维亚（5.5%），最高的是摩纳哥（41.4%）；19.3%的学生是当前吸烟者，比例最低的是冰岛（5.1%），最高的是意大利（32.4%）。与非使用者相比，当前电子烟使用者来自中等富裕家庭的比例较低（比值比（OR）=0.85，95%置信区间（CI）=0.80-0.90），且居住在香烟价格较高（OR=0.71，95%CI=0.50-0.99）、烟草广告和促销限制措施较强（OR=0.79，95%CI=0.63-0.99）、烟草控制措施中等实施（OR=0.57，95%CI=0.38-0.85）的国家。当前的电子烟使用者更有可能是终身吸烟者（OR=7.31，95%CI=6.47-8.25）、早期吸烟者（OR=4.35，95%CI=3.66-5.17）、男性（OR=1.61，95%CI=1.55-1.67）、来自非传统家庭（OR=1.43，95%CI=1.34-1.53）、父母受教育程度相对较低（OR=1.15，95%CI=1.10-1.20）。与不吸烟者相比，当前吸烟者与电子烟使用者具有相似的家庭特征，且更不可能生活在香烟价格较高（OR=0.70，95%CI=0.49-0.99）和公共反烟草媒体宣传支出较高（OR=0.23，95%CI=0.10-0.50）的国家。
欧洲青少年使用电子烟与较弱的烟草控制措施有关，特别是在烟草价格、广告和促销方面。除了预防吸烟外，欧洲国家采取的政府烟草控制政策似乎也有助于预防青少年吸电子烟。
