From the Department of Biostatistics, Pennington Biomedical Research Center, Baton Rouge, Louisiana, the Department of Statistics and Data Science, Carnegie Mellon University, Pittsburgh, Pennsylvania, and the Texas Tech University Health Sciences Center, Lubbock.
South Med J. 2022 Sep;115(9):665-673. doi: 10.14423/SMJ.0000000000001445.
Developing a comprehensive understanding of tobacco product use among adolescents requires information about the use of conventional cigarettes; electronic cigarettes (e-cigarettes); other tobacco products such as cigars, little cigars, and cigarillos (CCLCs); and smokeless tobacco. In particular, the use of products other than cigarettes may have important implications for additional smoking-related behaviors and the health of students and adolescents.
The National Youth Tobacco Surveys for 2017, 2018, and 2019 were aggregated to analyze the characteristics of middle school and high school students who had used tobacco products, such as CCLCs. Information collected included age, sex, race, and perceptions about harm and addiction related to tobacco products. Multiple logistic regression models were used to evaluate the associations between having used conventional/e-cigarettes and having used CCLCs, while adjusting for the perceived harm of conventional/e-cigarettes, sex, age, and other risk factors.
These combined surveys included 50,172 responses; 6836 respondents (13.6%) had tried CCLCs. Male students used these products more frequently than female students. Students in older age groups (15, 16, 17, and 18 and older,) had used these products more frequently than younger students. The odds for students in this CCLCs subgroup trying conventional cigarettes decreased in those who thought that conventional cigarettes could cause "some harm" or "a lot of harm." The odds for having tried e-cigarettes in the CCLCs subgroup decreased in those who thought that e-cigarettes could cause harm and increased in those who thought that conventional cigarettes could cause "little harm" or "a lot of harm."
More than 10% of middle school and high school students have used CCLCs. The majority of students in this subgroup also have used either conventional cigarettes or e-cigarettes. Understanding possible harm with cigarette use is significantly associated with the reduced use of conventional and e-cigarettes, and using CCLCs independently contributes to the increased risk of using conventional and e-cigarettes. The frequent use of several tobacco products makes surveys in this age group more complicated and indicates that educational efforts and public policies regarding tobacco need to include all tobacco products.
要全面了解青少年的烟草制品使用情况，需要了解传统香烟、电子烟（e-cigarettes）、雪茄、小雪茄和小雪茄（CCLCs）和无烟烟草等其他烟草制品的使用情况。特别是，使用除香烟以外的产品可能会对学生和青少年的其他与吸烟有关的行为和健康产生重要影响。
将 2017 年、2018 年和 2019 年的全国青少年烟草调查数据进行汇总，以分析使用 CCLC 等烟草制品的中学生和高中生的特征。收集的信息包括年龄、性别、种族以及对烟草制品相关危害和成瘾的认知。使用多因素逻辑回归模型评估了使用传统/e-cigarettes 和使用 CCLCs 之间的关联，同时调整了对传统/e-cigarettes 的感知危害、性别、年龄和其他风险因素的影响。
这些合并调查共包括 50172 份回复；6836 名受访者（13.6%）尝试过 CCLC。男学生比女学生更频繁地使用这些产品。年龄较大的学生（15、16、17 和 18 岁及以上）比年龄较小的学生更频繁地使用这些产品。在这个 CCLC 亚组中，认为传统香烟可能会造成“一些危害”或“大量危害”的学生尝试传统香烟的几率降低。在 CCLC 亚组中，认为电子烟可能会造成危害的学生尝试电子烟的几率降低，而认为传统香烟可能会造成“少量危害”或“大量危害”的学生尝试电子烟的几率增加。
超过 10%的中学生和高中生使用过 CCLC。该亚组中的大多数学生也使用过传统香烟或电子烟。对吸烟可能造成的危害的认识与传统和电子烟使用减少显著相关，而独立使用 CCLC 会增加使用传统和电子烟的风险。几种烟草制品的频繁使用使得该年龄段的调查更加复杂，并表明针对烟草的教育努力和公共政策需要包括所有烟草制品。
