Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.
School of Public Health, Indiana University, Bloomington, IN, USA.
Addiction. 2023 Mar;118(3):509-519. doi: 10.1111/add.16082. Epub 2022 Nov 26.
Most extant evidence has addressed between-person differences, short-term or cross-sectional associations of electronic nicotine delivery systems (ENDS) use with other substance use, the majority focusing on current rather than escalated use. The present study aimed to examine within-person changes in escalated ENDS use and their associations with individual and combined substance use over a 6-year period.
DESIGN, SETTING AND PARTICIPANTS: This study used a longitudinal cohort design with US young adults. A generalized linear mixed-model approach was employed to fit a series of weighted logistic regression models. Data were drawn from waves 1-5 of the Population Assessment of Tobacco and Health (PATH) study in the United States. Of the 9110 young adults at baseline, aged 18-24 years, a total of 5042 individuals had matched data across all five waves of assessments.
Escalated ENDS use was computed by subtracting the number of days of ENDS use within the past 30 days at wave from that at wave and coded as 1 = escalated, if the value was greater than zero (otherwise, coded as 0 = not escalated).
Escalated ENDS use gradually decreased over time, with the lowest prevalence at wave 4 (4.0%) but sharply increasing at wave 5 (8.4%). Escalated ENDS use was associated with increased odds of using each substance (binge drinking, marijuana use, marijuana vaping, prescription and illicit drugs) and different combinations of polysubstance use between cigarette smoking, binge drinking and marijuana use (Ps < 0.05). In addition, sweet/fruit flavor use (versus menthol/mint) was associated with increased likelihood of reporting co-use of cigarettes and marijuana.
In the United States, the prevalence of young adults using electronic nicotine delivery systems appears to have increased steadily between 2013 and 2019, although the rate of increase may have started to accelerate in recent years. Escalated electronic nicotine delivery systems use and time-lagged established electronic nicotine delivery systems use appear to be prospectively associated with individual and combined substance use, particularly between cigarettes, alcohol and marijuana. Among established electronic nicotine delivery systems users, sweet/fruit flavor appears to be associated with increased risk of co-using cigarettes and marijuana.
大多数现有证据都探讨了个体之间的差异、电子烟使用与其他物质使用之间的短期或横断面关联，其中大多数研究都集中在当前而非逐渐增加的使用上。本研究旨在检验在 6 年期间内，逐渐增加的电子烟使用的个体内变化及其与个体和联合物质使用的关联。
设计、地点和参与者：本研究使用了美国年轻成年人的纵向队列设计。采用广义线性混合模型方法拟合了一系列加权逻辑回归模型。数据来自美国人口烟草和健康评估（PATH）研究的第 1-5 波。在基线时，共有 9110 名 18-24 岁的年轻成年人，共有 5042 人在所有五次评估中都有匹配数据。
通过从第 波过去 30 天的电子烟使用天数中减去第 波的使用天数来计算逐渐增加的电子烟使用情况，并将其编码为 1=增加，如果该值大于零（否则，编码为 0=没有增加）。
逐渐增加的电子烟使用随着时间的推移逐渐减少，在第 4 波（4.0%）达到最低水平，但在第 5 波（8.4%）急剧增加。逐渐增加的电子烟使用与每种物质（狂欢饮酒、大麻使用、大麻蒸气吸入、处方和非法药物）使用的几率增加以及吸烟、狂欢饮酒和大麻使用之间不同的多物质使用组合（P 值均<0.05）相关。此外，甜味/水果味的使用（相对于薄荷/薄荷醇）与报告同时使用香烟和大麻的可能性增加相关。
在美国，年轻人使用电子烟的比例似乎在 2013 年至 2019 年间稳步上升，尽管近年来上升速度可能有所加快。逐渐增加的电子烟使用和有时间滞后的电子烟使用似乎与个体和联合物质使用，特别是香烟、酒精和大麻的使用呈前瞻性关联。在有使用电子烟习惯的人群中，甜味/水果味似乎与同时使用香烟和大麻的风险增加有关。
