Department of Management, Policy, & Community Health, University of Texas Health Science Center, 1200 Pressler Street, Houston, TX 77030, USA.
Department of Biostatistics and Data Science, University of Texas Health Science Center, 1200 Pressler Street, Houston, TX 77030, USA.
Int J Environ Res Public Health. 2024 Oct 18;21(10):1375. doi: 10.3390/ijerph21101375.
New-generation disposable e-cigarettes have become increasingly popular among young adults in the USA since the FDA's partial flavor ban. This study aims to examine longitudinal changes in health risks among young adults who adopted these novel products, as well as the health effects of device types beyond the effects of other important e-cigarette characteristics. This study recruited e-cigarette users via voluntary response sampling from three college campuses in the USA to respond to four-wave online surveys conducted in four consecutive semesters. Among the participants who adopted disposables during the study, their health risks (dependence symptoms, respiratory symptoms, combustible tobacco use) and e-cigarette consumption characteristics (use frequency, nicotine concentration and flavors) before and after the adoption were compared using paired-sample t- or McNemar's tests. Generalized linear mixed models with a random intercept were conducted on data from the entire sample to investigate the effects of device type (tank, cartridge/pod, disposable) on health risks, controlling for other e-cigarette consumption characteristics. The study sample of 650 e-cigarette users were, on average, 20 years old, with 49% being male, 70% being White, and 13% being Hispanic. Adopting disposables may increase secondary dependence motives (t = 2.42, < 0.05) and the use of higher levels of nicotine concentration (t = 2.09, < 0.05) and sweet flavors (x = 22.53, < 0.05) but decrease the number of times of vaping per day (t = -2.18, < 0.05) and the use of menthol flavors (x = 4.57, < 0.05). Tank use is associated with a higher level of primary dependence motives (b = 0.1998, < 0.05) and a greater odds of using combustible tobacco (b = 0.4772, < 0.05). Although disposable use is not associated with the likelihood of using combustible tobacco, it is associated with higher levels of both primary (b = 0.2158, < 0.05) and secondary (b = 0.2533, < 0.05) dependence motives. It is not the device type, but rather the frequency of vaping, that affects respiratory symptoms (b = 0.0602, < 0.05). The findings indicate that when young adults switch to disposables, their e-cigarette dependence and use of sweet-flavored e-liquids increase. Even after controlling for use frequency, nicotine concentration and flavors, using disposables is related to not only instrumental motives that are influenced by psychological and environmental contexts but also heavy, automatic use that can operate without environmental cues. Given the health risks associated with disposable e-cigarettes, more comprehensive tobacco product regulations that consider the impact of device types may be needed.
新一代一次性电子烟在美国 FDA 部分口味禁令实施后，在年轻人中越来越受欢迎。本研究旨在研究采用这些新型产品的年轻人健康风险的纵向变化，以及除其他重要电子烟特征外，设备类型对健康的影响。本研究通过自愿反应抽样从美国三所大学校园招募电子烟使用者，在四个连续学期进行了四轮在线调查。在研究期间采用一次性电子烟的参与者中，使用配对样本 t 检验或 McNemar 检验比较了他们在采用前后的健康风险（依赖症状、呼吸道症状、可燃烟草使用）和电子烟消费特征（使用频率、尼古丁浓度和口味）。对整个样本的数据进行了带有随机截距的广义线性混合模型分析，以研究设备类型（罐式、盒式/盒式、一次性）对健康风险的影响，同时控制其他电子烟消费特征。研究样本包括 650 名电子烟使用者，平均年龄为 20 岁，其中 49%为男性，70%为白人，13%为西班牙裔。采用一次性电子烟可能会增加次要依赖动机（t = 2.42， < 0.05）和使用更高水平的尼古丁浓度（t = 2.09， < 0.05）和甜味口味（x = 22.53， < 0.05），但会减少每天吸烟的次数（t = -2.18， < 0.05）和使用薄荷醇口味（x = 4.57， < 0.05）。罐式使用与更高水平的主要依赖动机（b = 0.1998， < 0.05）和使用可燃烟草的更大几率（b = 0.4772， < 0.05）相关。尽管一次性使用与使用可燃烟草的可能性无关，但它与主要（b = 0.2158， < 0.05）和次要（b = 0.2533， < 0.05）依赖动机都呈正相关。影响呼吸道症状的是电子烟的使用频率（b = 0.0602， < 0.05），而不是设备类型。研究结果表明，当年轻人转向使用一次性电子烟时，他们的电子烟依赖和使用甜味电子烟的情况会增加。即使在控制使用频率、尼古丁浓度和口味后，使用一次性电子烟不仅与受心理和环境背景影响的工具性动机有关，而且还与没有环境线索也能运作的重度、自动使用有关。鉴于与一次性电子烟相关的健康风险，可能需要更全面的烟草产品法规，以考虑设备类型的影响。
