2002 - 2019年美国青少年吸烟的累积心理社会和健康差异

Cumulative psychosocial and health disparities in US adolescent cigarette smoking, 2002-2019.

作者信息

Erath Tyler G, Chen Fang Fang, DeSarno Michael, Devine Derek, Leventhal Adam M, Bickel Warren K, Higgins Stephen T

机构信息

Vermont Center on Behavior and Health, University of Vermont, Burlington, VT 05405, United States.

Department of Psychiatry, University of Vermont, Burlington, VT 05405, United States.

出版信息

J Natl Cancer Inst. 2025 Apr 1;117(4):665-672. doi: 10.1093/jnci/djae286.

DOI:10.1093/jnci/djae286

PMID:39535862

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11972670/

Abstract

BACKGROUND

Understanding disparities in adolescent cigarette smoking is important for effective prevention.

METHODS

We investigated disparities in adolescent smoking based on cumulative reported psychosocial and health risk among respondents ages 12-17 years in the US National Survey of Drug Use and Health from 2002 to 2019. Multivariable regression estimated associations of cumulative risk, survey years, and their interaction predicting past-month and daily smoking. Eleven psychosocial and health variables associated with youth smoking formed composite measures of cumulative risk, categorizing risk as low (0-2), moderate (3-4), or high (≥5). The main outcomes were weighted past-month and daily smoking by cumulative risk and time, examining prevalence and proportional change across years.

RESULTS

Among 244 519 adolescents, greater cumulative risk predicted higher smoking prevalence across all outcomes. Compared with the low-risk category, past-month smoking odds (adjusted odds ratio) were 9.14 (95% confidence interval [CI] = 8.58 to 9.72) and 46.15 (95% CI = 43.38 to 49.10) times greater in the moderate-risk and high-risk categories. For daily smoking, odds were 14.11 (95% CI = 11.92 to 16.70) and 97.32 (95% CI = 83.06 to 114.03) times greater among the moderate-risk and high-risk categories. Regarding proportional change, the low-risk category exhibited the steepest decline (-85.1%) in past-month smoking from 2002-2003 to 2018-2019, followed by the moderate-risk (-79.2%) and high-risk (-65.7%) categories. Daily smoking declined more steeply among the low-risk (-96.5%) and moderate-risk (-90.5%) than high-risk category (-86.4%).

CONCLUSIONS

Cumulative risk is a robust predictor of adolescent smoking. Although record-setting reductions in adolescent smoking extend across risk categories, disparities favoring youth with fewer risks are evident throughout. Recognizing cumulative risk can inform the development of more targeted and effective prevention efforts.

摘要

背景

了解青少年吸烟差异对于有效预防至关重要。

方法

我们基于2002年至2019年美国全国药物使用和健康调查中12至17岁受访者报告的累积心理社会和健康风险，调查了青少年吸烟差异。多变量回归估计了累积风险、调查年份及其交互作用与过去一个月吸烟和每日吸烟之间的关联。与青少年吸烟相关的11个心理社会和健康变量构成了累积风险的综合指标，将风险分为低（0 - 2）、中（3 - 4）或高（≥5）。主要结果是按累积风险和时间加权的过去一个月吸烟和每日吸烟情况，研究各年份的患病率和比例变化。

结果

在244519名青少年中，累积风险越高，所有结果中的吸烟患病率越高。与低风险类别相比，中度风险和高风险类别中过去一个月吸烟的几率（调整后的优势比）分别是低风险类别的9.14倍（95%置信区间[CI]=8.58至9.72）和46.15倍（95%CI = 43.38至49.10）。对于每日吸烟，中度风险和高风险类别中的几率分别是低风险类别的14.11倍（95%CI = 11.92至16.70）和97.32倍（95%CI = 83.06至114.03）。关于比例变化，从2002 - 2003年到2018 - 2019年，低风险类别过去一个月吸烟的下降幅度最大（-85.1%），其次是中度风险（-79.2%）和高风险（-65.7%）类别。低风险（-96.5%）和中度风险（-90.5%）类别中每日吸烟的下降幅度比高风险类别（-86.4%）更大。