Assari Shervin, Zare Hossein, Sheikhattari Payam
Charles R. Drew University of Medicine and Science, Los Angeles, CA, United States.
Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States.
J Biomed Life Sci. 2024;4(1):27-35. doi: 10.31586/jbls.2024.1038. Epub 2024 Sep 4.
Early initiation of tobacco use among adolescents is a significant public health concern. While there is extensive research on overall tobacco use, much of it focuses on initiation in late adolescence, uses cross-sectional designs, and lacks specific exploration of electronic versus conventional cigarette use. This study aims to investigate social determinants influencing the early initiation of electronic and conventional cigarette use among U.S. adolescents.
We utilized data from the Adolescent Brain Cognitive Development (ABCD) study, which follows a cohort of tobacco-naïve children from age nine through age 16. The social determinants examined included household income, parental education, financial difficulties, racial/ethnic minority status, family structure, neighborhood income, and gender minority status. Structural equation models were employed to assess associations between these determinants and early initiation of electronic and conventional cigarette use.
Male gender was associated with a higher likelihood of conventional cigarette use, while the risk of early initiation of electronic cigarette use was similar across genders. White adolescents were at a higher risk of conventional cigarette use; however, the risk for electronic cigarette use was comparable across White and non-White groups. Financial difficulties were linked to an increased likelihood of early initiation of conventional cigarette use but not electronic cigarette use. Higher household income was associated with a reduced risk of initiating conventional cigarettes but did not significantly impact electronic cigarette use. Adolescents from married families were less likely to initiate electronic cigarette use. No significant effects were found for parental education or neighborhood income on the initiation of either type of cigarette use. Age did not significantly affect the initiation of either cigarette type, and gender minority status was marginally associated with early initiation of conventional cigarette use.
The social patterning of electronic cigarette use differs from that of conventional cigarette use, suggesting that distinct tobacco products do not pose a uniform risk across all adolescents. This study underscores the importance of tailored prevention efforts that address the unique challenges associated with early initiation of electronic and conventional cigarette use among adolescents. The differential risk factors identified suggest targeted prevention strategies for conventional cigarette use, focusing on financial difficulties, household income, and gender-specific interventions. In contrast, prevention efforts for electronic cigarette use may require broader, more inclusive approaches that address all adolescents, regardless of their background. Comprehensive universal screening for electronic cigarette use and targeted screening for conventional cigarette use among adolescents are recommended.
青少年过早开始使用烟草是一个重大的公共卫生问题。虽然对总体烟草使用有广泛研究，但其中大部分集中在青少年晚期开始使用的情况，采用横断面设计，并且缺乏对电子烟与传统香烟使用的具体探索。本研究旨在调查影响美国青少年过早开始使用电子烟和传统香烟的社会决定因素。
我们利用了青少年大脑认知发展（ABCD）研究的数据，该研究跟踪了一群从9岁到16岁未使用过烟草的儿童。所考察的社会决定因素包括家庭收入、父母教育程度、经济困难、种族/族裔少数群体身份、家庭结构、邻里收入和性别少数群体身份。采用结构方程模型来评估这些决定因素与过早开始使用电子烟和传统香烟之间的关联。
男性使用传统香烟的可能性更高，而过早开始使用电子烟的风险在不同性别之间相似。白人青少年使用传统香烟的风险更高；然而，白人和非白人群体使用电子烟的风险相当。经济困难与过早开始使用传统香烟的可能性增加有关，但与过早开始使用电子烟无关。较高的家庭收入与开始使用传统香烟的风险降低有关，但对电子烟使用没有显著影响。来自已婚家庭的青少年开始使用电子烟的可能性较小。未发现父母教育程度或邻里收入对任何一种香烟使用的开始有显著影响。年龄对任何一种香烟类型的开始使用均无显著影响，性别少数群体身份与过早开始使用传统香烟略有关联。
电子烟使用的社会模式与传统香烟使用不同，这表明不同的烟草产品对所有青少年并不构成统一的风险。本研究强调了针对性预防措施的重要性，这些措施要应对与青少年过早开始使用电子烟和传统香烟相关的独特挑战。所确定的不同风险因素表明了针对传统香烟使用的有针对性的预防策略，重点关注经济困难、家庭收入和针对性别的干预措施。相比之下，电子烟使用的预防措施可能需要更广泛、更具包容性的方法，以应对所有青少年，无论其背景如何。建议对青少年进行全面的电子烟使用普遍筛查和对传统香烟使用进行针对性筛查。
