American Heart Association Tobacco Center for Regulatory Science, Dallas, Texas, United States of America.
New York University Grossman School of Medicine, New York, New York, United States of America.
PLoS One. 2024 Sep 27;19(9):e0308964. doi: 10.1371/journal.pone.0308964. eCollection 2024.
Understanding the association between initial experimentation with a tobacco product and subsequent patterns of tobacco use among youth is important to informing prevention activities for youth in the US. We conducted an online survey from August to October 2017 among youth aged 13-18 years. The current analysis focused on respondents reporting initial experimentation with any tobacco product (n = 2,022). Using multinomial logistic regression, we examined the association between first tobacco product tried (cigarettes; cigars including cigarillos, little cigars, and bidis; electronic nicotine delivery systems (ENDS); smokeless and chewing tobacco; or hookah) with subsequent patterns of tobacco use while adjusting for covariates. Of the youth who experimented, 56.8% were non-current tobacco users. Of current tobacco users (n = 934), 13% were exclusive ENDS users, 5.3% exclusive combustible mono-users, 13.4% ENDS plus combustible poly-users, 3.3% combustible product only poly-users, and 8.2% other tobacco poly-users. The most common type of first tobacco product tried was ENDS (44.7%), followed by cigarettes (35.0%) and cigars (8.6%). Those who experimented with combustible tobacco products were less likely to be exclusive ENDS users [Relative Risk Ratio (RRR) = 0.46; 95% CI = 0.28, 0.73 for cigarettes; RRR = 0.32; 95% CI = 0.13, 0.81 for cigars; and RRR = 0.33; 95% CI = 0.14, 0.79 for hookah] when compared to non-current tobacco users (reference group). Tobacco product choices for initial experimentation appear to play a role in subsequent tobacco use patterns among youth. Understanding the reasons behind initial product choice may inform our understanding regarding the reasons for subsequent current tobacco product use, thus informing youth prevention efforts.
了解青少年初次尝试使用烟草产品与随后的烟草使用模式之间的关系，对于为美国青少年开展预防活动具有重要意义。我们于 2017 年 8 月至 10 月期间，对年龄在 13-18 岁的青少年进行了一项在线调查。本分析主要关注报告初次尝试使用任何烟草产品的受访者（n=2022）。我们采用多项逻辑回归，在调整协变量的基础上，检验了最初尝试的烟草产品（香烟；雪茄包括小雪茄、小雪茄和比迪烟；电子烟；无烟烟草和咀嚼烟草；或水烟）与随后的烟草使用模式之间的关联。在尝试过烟草产品的青少年中，56.8%是非当前烟草使用者。在当前烟草使用者中（n=934），13%是纯电子烟使用者，5.3%是纯可燃烟单用户，13.4%是电子烟和可燃烟混合使用者，3.3%是仅可燃烟混合使用者，8.2%是其他烟草混合使用者。初次尝试的最常见烟草产品类型是电子烟（44.7%），其次是香烟（35.0%）和雪茄（8.6%）。与非当前烟草使用者（参照组）相比，尝试使用可燃烟草产品的人不太可能成为纯电子烟使用者[相对风险比（RRR）=0.46；95%置信区间（CI）=0.28，0.73 用于香烟；RRR=0.32；95%CI=0.13，0.81 用于雪茄；和 RRR=0.33；95%CI=0.14，0.79 用于水烟]。青少年初次尝试使用的烟草产品选择似乎对随后的烟草使用模式有一定影响。了解最初产品选择的原因可能有助于我们了解随后使用当前烟草产品的原因，从而为青少年预防工作提供信息。
