Erhabor John, Boakye Ellen, Osuji Ngozi, Obisesan Olufunmilayo, Osei Albert D, Mirbolouk Hassan, Stokes Andrew C, Dzaye Omar, El-Shahawy Omar, Rodriguez Carlos J, Hirsch Glenn A, Benjamin Emelia J, DeFilippis Andrew P, Robertson Rose Marie, Bhatnagar Aruni, Blaha Michael J
Johns Hopkins Ciccarone Center for Prevention of Cardiovascular Disease, Baltimore, MD, USA.
American Heart Association Tobacco Regulation and Addiction Center, Dallas, TX, USA.
Prev Med Rep. 2023 Apr 15;33:102207. doi: 10.1016/j.pmedr.2023.102207. eCollection 2023 Jun.
Among adolescents, sole use is the most common pattern of e-cigarette use. However, concurrent use of e-cigarettes with other tobacco products is not uncommon and may be associated with high-risk behaviors. We used data from 12,767 participants in the 2019 Youth Risk Behavior Survey to examine the patterns of tobacco product use among youth in the US. First, we examined the prevalence of e-cigarette-specific patterns of tobacco use (nonuse[no tobacco product use], sole use[sole e-cigarette use], dual-use[e-cigarette and one other tobacco product], and poly use[e-cigarette and two or more other tobacco products]). Then, using multivariable Poisson regression, we assessed how the tobacco use patterns were associated with the misuse of nine substances of abuse (alcohol, marijuana, cocaine, ecstasy, hallucinogens, heroin, inhalants, injectables, and methamphetamines). 62.9% of youth reported nonuse of any tobacco product. The weighted prevalence of sole e-cigarette use, dual use, and poly use was 23.2%, 4.2%, and 3.3%, respectively. Across all the substances explored, the prevalence was highest among poly users, followed by dual users, sole users, and non-users. Compared to non-users, sole, dual, and poly users had 7.8(95 %CI:6.1-10.0), 14.3(95 %CI:10.8-18.8), and 19.7(95 %CI:15.0-25.9) times higher adjusted prevalence of reporting past-30-day binge drinking, after adjusting for age, sex, race/ethnicity, sexual orientation, and depressive symptoms. This pattern was seen across all the different substances explored. These findings highlight the high prevalence of substance misuse among youth who use tobacco products and the need to educate and counsel on substances of abuse among this population, particularly among poly-tobacco users.
在青少年中，单独使用电子烟是最常见的使用模式。然而，同时使用电子烟和其他烟草制品的情况并不少见，且可能与高风险行为有关。我们使用了2019年青少年风险行为调查中12767名参与者的数据，来研究美国青少年的烟草制品使用模式。首先，我们研究了特定于电子烟的烟草使用模式的流行情况（不使用[不使用任何烟草制品]、单独使用[仅使用电子烟]、双重使用[使用电子烟和另一种烟草制品]以及多重使用[使用电子烟和两种或更多其他烟草制品]）。然后，我们使用多变量泊松回归，评估了烟草使用模式与九种滥用物质（酒精、大麻、可卡因、摇头丸、致幻剂、海洛因、吸入剂、注射剂和甲基苯丙胺）的滥用之间的关联。62.9%的青少年报告未使用任何烟草制品。仅使用电子烟、双重使用和多重使用的加权流行率分别为23.2%、4.2%和3.3%。在所有研究的物质中，多重使用者中的流行率最高，其次是双重使用者、单独使用者和不使用者。在调整了年龄、性别、种族/族裔、性取向和抑郁症状后，与不使用者相比，单独使用者、双重使用者和多重使用者报告过去30天内暴饮的调整后流行率分别高7.8倍（95%置信区间：6.1 - 10.0）、14.3倍（95%置信区间：10.8 - 18.8）和19.7倍（95%置信区间：15.0 - 25.9）。在所有研究的不同物质中都观察到了这种模式。这些发现凸显了使用烟草制品的青少年中物质滥用的高流行率，以及对这一人群，特别是多重烟草使用者进行关于滥用物质的教育和咨询的必要性。
