Adebisi Yusuff Adebayo, Bafail Duaa Abdullah
College of Social Sciences, University of Glasgow, Glasgow, UK.
Department of Clinical Pharmacology, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia.
Intern Emerg Med. 2025 Mar;20(2):441-452. doi: 10.1007/s11739-024-03817-y. Epub 2024 Nov 15.
The health implications of e-cigarette use compared to traditional cigarette smoking continue to attract significant public health interest. This study examines self-rated health (SRH) outcomes among exclusive e-cigarette users versus exclusive traditional cigarette smokers, using data from the Health Survey for England 2019. From an initial sample of 10,299 participants, the study focused on 8204 adults, excluding those aged 0-15. Further refinement to exclusive nicotine product users led to 274 e-cigarette users and 1017 cigarette smokers, after excluding dual users, never users, ex-users, non-responders, and users of other tobacco products such as pipes and cigars. SRH was derived from participants' responses to a question asking how they rated their general health, with five possible options: "very good", "good", "fair", "bad", and "very bad". For the purposes of this study, these responses were collapsed into two categories: "Good Health" (combining "very good" and "good") and "Poor Health" (combining "fair", "bad", and "very bad"). Consequently, 834 participants were classified as reporting good health, while 457 reported poor health. Binary logistic regression, adjusted for factors such as age, sex, ethnicity, residence, education, body mass index, alcohol use, age started smoking, physical or mental health conditions, and frequency of GP visits, revealed that exclusive e-cigarette users were significantly more likely to report good health compared to exclusive cigarette smokers, with an odds ratio (OR) of 1.59 (95% CI: 1.10 - 2.32, p = 0.014). As a sensitivity analysis, a generalized ordered logistic regression model was performed using the original five SRH categories. The adjusted model confirmed consistent results, with exclusive e-cigarette users showing higher odds of reporting better health across the full range of SRH outcomes (OR = 1.40, 95% CI: 1.08-1.82, p = 0.011). These findings suggest that exclusive e-cigarette users perceive their health more positively than traditional cigarette smokers, contributing useful insights to the discussions around harm reduction strategies.
与传统吸烟相比,使用电子烟对健康的影响一直备受公众健康关注。本研究利用2019年英格兰健康调查的数据,调查了仅使用电子烟者与仅使用传统香烟者的自评健康(SRH)结果。在最初的10299名参与者样本中,该研究聚焦于8204名成年人,不包括0至15岁的人群。进一步筛选出仅使用尼古丁产品的用户,在排除同时使用两种产品者、从不使用者、曾经使用者、未回应者以及使用烟斗和雪茄等其他烟草产品的用户后,得到274名电子烟使用者和1017名吸烟者。SRH来自参与者对一个询问他们如何评价自己总体健康状况的问题的回答,有五个可能的选项:“非常好”、“好”、“一般”、“差”和“非常差”。在本研究中,这些回答被归纳为两类:“健康良好”(合并“非常好”和“好”)和“健康不佳”(合并“一般”、“差”和“非常差”)。因此,834名参与者被归类为报告健康良好,而457名报告健康不佳。在对年龄、性别、种族、居住地区、教育程度、体重指数、饮酒情况、开始吸烟年龄、身体或心理健康状况以及看全科医生的频率等因素进行调整后,二元逻辑回归显示,与仅吸烟者相比,仅使用电子烟者报告健康良好的可能性显著更高,优势比(OR)为1.59(95%置信区间:1.10 - 2.32,p = 0.014)。作为敏感性分析,使用原始的五个SRH类别进行了广义有序逻辑回归模型分析。调整后的模型证实了一致的结果,在整个SRH结果范围内,仅使用电子烟者报告健康状况更好的几率更高(OR = 1.40,95%置信区间:1.08 - 1.82,p = 0.011)。这些发现表明,仅使用电子烟者对自己健康的看法比传统吸烟者更积极,为围绕减少危害策略的讨论提供了有用的见解。
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