传统香烟和电子烟使用与中国青少年自杀意念的关联：性别和学校类型的调节作用。
Association of conventional and electronic cigarette use with suicidality in Chinese adolescents: The moderating effect of sex and school type.
机构信息
Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China.
Center for ADR monitoring of Guangdong, Guangzhou, China.
出版信息
J Affect Disord. 2024 Nov 15;365:492-500. doi: 10.1016/j.jad.2024.08.126. Epub 2024 Aug 24.
BACKGROUND
To estimate the prevalence of lifetime e-cigarette use and explore the association between lifetime conventional and electronic cigarette use with suicidality among Chinese adolescents, focusing on sex and school-type differences.
METHODS
A total of 22,509 students from 432 classes in 80 schools were recruited in Guangdong Province using a multistage, stratified cluster, random sampling method in 2021. Self-report questionnaires were used to collect information. Multivariable logistic regression models were performed and stratification analysis was conducted. All analyses were weighted and adjusted for the complex survey design.
RESULTS
The weighted prevalence of lifetime e-cigarette use among adolescents in Guangdong Province was 8.7 % (4.3 % were dual users and 4.4 % were e-cigarette-only users) and 2.6 % were conventional-cigarette-only users. Lifetime e-cigarette-only users (AOR [Adjusted OR] =1.46, 95 % CI = 1.21-1.76), conventional-cigarette-only users (AOR = 1.97, 95 % CI = 1.58-2.46) and dual users (AOR = 1.67, 95 % CI = 1.38-2.02) were at a higher risk of suicidal ideation than non-users. Lifetime e-cigarette-only users (AOR = 2.03, 95 % CI = 1.53-2.70), conventional-cigarette-only users (AOR = 1.97, 95 % CI = 1.42-2.73), and dual users (AOR = 2.76, 95 % CI = 2.10-3.61) had a significantly higher risk of suicide attempts than non-users. After further analysis stratified by sex and school type, the associations of lifetime cigarette use patterns with suicidality slightly varied.
LIMITATION
The cross-sectional study design and self-report information.
CONCLUSION
The prevalence of e-cigarettes among Chinese adolescents is concerning. Lifetime conventional and e-cigarette use were associated with suicidality among Chinese adolescents, with sex and school type moderating these associations. Targeted measures to restrict cigarette use, including new tobacco product (e-cigarette) use, among adolescents are warranted.
背景
本研究旨在估计中国青少年终生使用电子烟的流行率，并探讨终生使用传统香烟和电子烟与自杀意念和自杀企图之间的关系，同时关注性别和学校类型差异。
方法
本研究采用多阶段、分层整群随机抽样方法，于 2021 年从广东省 80 所学校的 432 个班级中招募了 22509 名学生。使用自报式问卷收集信息。采用多变量逻辑回归模型进行分析，并进行了分层分析。所有分析均进行了加权处理，并针对复杂的调查设计进行了调整。
结果
广东省青少年终生电子烟使用率为 8.7%（4.3%为双重使用者，4.4%为电子烟使用者），传统香烟使用者为 2.6%。终生电子烟使用者（调整后的 OR [比值比] =1.46，95%可信区间 [置信区间] =1.21-1.76）、传统香烟使用者（AOR=1.97，95%CI=1.58-2.46）和双重使用者（AOR=1.67，95%CI=1.38-2.02）自杀意念的风险均高于非使用者。终生电子烟使用者（AOR=2.03，95%CI=1.53-2.70）、传统香烟使用者（AOR=1.97，95%CI=1.42-2.73）和双重使用者（AOR=2.76，95%CI=2.10-3.61）自杀企图的风险均显著高于非使用者。进一步按性别和学校类型进行分层分析后，吸烟模式与自杀意念的关联略有变化。
局限性
本研究为横断面研究设计，且信息来源于自报。
结论
中国青少年电子烟的使用情况令人担忧。终生使用传统香烟和电子烟与中国青少年的自杀意念和自杀企图有关，且这些关联受到性别和学校类型的调节。需要采取有针对性的措施来限制青少年包括新烟草制品（电子烟）在内的吸烟行为。
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