Department of Community Medicine, Mahidol University Faculty of Medicine Ramathibodi Hospital, Bangkok, Thailand
Department of Community Medicine, Mahidol University Faculty of Medicine Ramathibodi Hospital, Bangkok, Thailand.
Tob Control. 2024 Apr 19;33(3):310-316. doi: 10.1136/tc-2022-057491.
This study quantifies the longitudinal association between e-cigarette use and subsequent conventional cigarette initiation and vice versa among Thai youths.
Data from a longitudinal survey of 6045 Thai seventh grade students with baseline in 2019 and the 12-month follow-up in 2020 were analysed using complex survey multivariate logistic regressions to assess whether e-cigarette use was associated with subsequent cigarette smoking (ever, current and dual product users at follow-up) among baseline never smokers.
Consistent with prior findings from other countries, among those who had never smoked cigarettes at baseline, ever e-cigarette users were more likely to try cigarette smoking (adjusted OR 4.44; 95% CI 2.23 to 8.86; p<0.001), or become dual users (adjusted OR 5.31; 95% CI 2.63 to 10.74; p<0.001) 1 year later. Baseline current e-cigarette users were more likely to become ever smokers (adjusted OR 5.37; 95% CI 1.82 to 15.90; p=0.005), current smokers (OR 3.92; 95% CI 1.69 to 9.14; p=0.003) and dual product users (adjusted OR 6.96; 95% CI 1.54 to 31.38; p=0.015) at the 12-month follow-up than non-e-cigarette users. Similarly, among never e-cigarette users at baseline, ever cigarette smoking were more likely to try e-cigarettes (adjusted OR 3.38; 95% CI 1.66 to 6.88; p=0.002), currently use e-cigarettes (adjusted OR 2.75; 95% CI 1.47 to 5.13; p=0.003) and currently use both e-cigarettes and cigarettes (adjusted OR 4.87; 95% CI 2.92 to 8.13; p<0.001) at the follow-up than never smokers. Among never e-cigarette users at baseline, current-cigarette smoking were more likely to try e-cigarettes (adjusted OR 6.21; 95% CI 2.58 to 14.95; p<0.001), currently use e-cigarettes (adjusted OR 2.80; 95% CI 1.27 to 6.14; p=0.014) and currently use both e-cigarettes and cigarettes (adjusted OR 7.70; 95% CI 3.45 to 17.19; p<0.001) at the follow-up than never smokers.
This longitudinal study in Asian low-income and middle-income countries supports the prospective association of youth e-cigarette use with subsequent smoking initiation and youth cigarette use with subsequent e-cigarette initiation that is similar to that observed in high-income Western countries.
引言：本研究旨在量化泰国青少年电子烟使用与随后常规香烟使用之间的纵向关联，以及反之亦然。
方法：本研究使用复杂调查多变量逻辑回归分析了一项针对 6045 名泰国七年级学生的纵向调查数据，该调查于 2019 年进行基线调查，2020 年进行 12 个月的随访。该研究评估了在基线时从未吸烟的人群中，电子烟使用是否与随后的吸烟行为（随访时的曾经吸烟、当前吸烟和双重产品使用者）有关。
结果：与其他国家的先前发现一致，在基线时从未吸烟的人群中，曾经使用电子烟的人更有可能尝试吸烟（调整后的比值比 4.44；95%置信区间 2.23 至 8.86；p<0.001），或成为双重使用者（调整后的比值比 5.31；95%置信区间 2.63 至 10.74；p<0.001）。基线时当前使用电子烟的人更有可能成为曾经吸烟者（调整后的比值比 5.37；95%置信区间 1.82 至 15.90；p=0.005）、当前吸烟者（比值比 3.92；95%置信区间 1.69 至 9.14；p=0.003）和双重产品使用者（调整后的比值比 6.96；95%置信区间 1.54 至 31.38；p=0.015）。同样，在基线时从未使用过电子烟的人群中，曾经吸烟的人更有可能尝试电子烟（调整后的比值比 3.38；95%置信区间 1.66 至 6.88；p=0.002）、目前使用电子烟（调整后的比值比 2.75；95%置信区间 1.47 至 5.13；p=0.003）和目前同时使用电子烟和香烟（调整后的比值比 4.87；95%置信区间 2.92 至 8.13；p<0.001）。在基线时从未使用过电子烟的人群中，目前吸烟的人更有可能尝试电子烟（调整后的比值比 6.21；95%置信区间 2.58 至 14.95；p<0.001）、目前使用电子烟（调整后的比值比 2.80；95%置信区间 1.27 至 6.14；p=0.014）和目前同时使用电子烟和香烟（调整后的比值比 7.70；95%置信区间 3.45 至 17.19；p<0.001）。
结论：这项在亚洲低收入和中等收入国家进行的纵向研究支持了这样一种观点，即青少年电子烟使用与随后的吸烟起始之间存在前瞻性关联，青少年吸烟与随后的电子烟使用之间也存在类似的关联，这与在高收入西方国家观察到的情况相似。
