Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China.
School of Public Health and Management, Wenzhou Medical University, Wenzhou, China.
Front Public Health. 2024 Jan 4;11:1321457. doi: 10.3389/fpubh.2023.1321457. eCollection 2023.
The worldwide popularity of electronic cigarettes (ECIG) is becoming a public health concern. Compared to conventional cigarettes (CIG), the harm caused by ECIG is more insidious. Studies have shown that lower health literacy (HL) is associated with CIG use; however, the relationship between HL and ECIG use remains controversial. Because ECIG emerged more recently than CIG, there are fewer relevant studies, and the sample populations and evaluation methods of HL in existing studies differ. This study conducted a large-sample survey to examine the relationship between HL and ECIG use.
As part of the 2022 China Health Literacy Survey, a total of 60,998 valid questionnaires were collected from September to November in 2022 using a stratified multistage probability proportional to the population size sampling frame. Chi-square tests and multinomial logistic regression was used to analyze the relationship between HL and ECIG use. Some demographic variables were included as covariates in the analysis.
The study showed that the average HL score and the HL level of Zhejiang residents in 2022 were 42.8 and 30.8%, respectively. The prevalence of CIG and ECIG was 19.7 and 1.0%, respectively; 19% of participants exclusively used CIG, while only 0.3% of participants used ECIG exclusively; dual users accounted for 0.6%. After adjusting for covariates, adequate HL was associated with lower odds of ECIG-exclusive use (odds ratio [OR] = 0.452, < 0.001), CIG-exclusive use (OR = 0.833, < 0.001), and dual use (OR = 0.632, < 0.001). Young age, male sex, unmarried status, high-income status, and absence of chronic disease were also associated with ECIG use.
HL was a protective factor against both patterns of ECIG use, especially ECIG-exclusive use. Health policymakers and public health practitioners should consider HL as a potential measure for ECIG control.
电子烟（ECIG）在全球范围内的普及正成为一个公共卫生关注点。与传统香烟（CIG）相比，ECIG 造成的危害更为隐匿。研究表明，健康素养（HL）较低与 CIG 使用有关；然而，HL 与 ECIG 使用之间的关系仍存在争议。由于 ECIG 的出现时间晚于 CIG，因此相关研究较少，而且现有研究的 HL 样本人群和评估方法也不同。本研究进行了一项大规模调查，以检验 HL 与 ECIG 使用之间的关系。
作为 2022 年中国健康素养调查的一部分，于 2022 年 9 月至 11 月采用分层多阶段与人口规模成比例的概率抽样框架，共收集了 60998 份有效问卷。采用卡方检验和多项逻辑回归分析 HL 与 ECIG 使用之间的关系。在分析中纳入了一些人口统计学变量作为协变量。
研究结果显示，2022 年浙江省居民的平均 HL 得分为 42.8 分，HL 水平为 30.8%。CIG 和 ECIG 的流行率分别为 19.7%和 1.0%；19%的参与者仅使用 CIG，而仅有 0.3%的参与者仅使用 ECIG；双重使用者占 0.6%。调整协变量后，充分的 HL 与 ECIG 独家使用（比值比 [OR] = 0.452， < 0.001）、CIG 独家使用（OR = 0.833， < 0.001）和双重使用（OR = 0.632， < 0.001）的可能性较低相关。年龄较小、男性、未婚、高收入和无慢性病也与 ECIG 使用有关。
HL 是 ECIG 使用模式（尤其是 ECIG 独家使用）的保护因素。卫生政策制定者和公共卫生从业者应将 HL 视为 ECIG 控制的潜在措施。
