Richardson Maggie K, Mattingly Delvon T, Agbonlahor Osayande, McLeish Alison C, Hart Joy L, Walker Kandi L
Department of Education, Counseling, and School Psychology, University of Kentucky College of Education, Lexington, Kentucky.
Center for Health, Engagement, and Transformation and Department of Behavioral Science, University of Kentucky College of Medicine, Lexington, Kentucky.
J Stud Alcohol Drugs. 2025 Sep;86(5):703-713. doi: 10.15288/jsad.24-00310. Epub 2025 Feb 6.
Despite a decline in cigarette use, the dual use of cigarettes and electronic vaping products (EVPs) is a concerning pattern of nicotine consumption in the United States. Anxiety, a risk factor for tobacco use, may contribute to dual-use patterns; however, the association between daily anxiety symptoms and dual use of cigarettes and EVPs is not known. This study investigated associations between daily anxiety symptoms and dual cigarette and EVP use overall and by sex, race, and ethnicity.
Data are from the 2020-2022 National Health Interview Survey ( = 83,544). Multinomial logistic regression models, adjusted for sociodemographic factors, tobacco use, mental health services, and medication characteristics, examined the relationship between daily anxiety and current exclusive/dual cigarette and EVP use. Stratified analyses explored effect modification by sex, race, and ethnicity.
Among the sample, 13.0% reported daily anxiety symptoms, and 1.3% reported dual cigarette and EVP use. Daily anxiety was associated with increased odds of exclusive cigarette (odds ratio [OR] = 1.54, 95% CI [1.42, 1.68]), exclusive EVP (OR = 1.44, 95% CI [1.23, 1.68]), and dual use (OR = 2.16, 95% CI [1.77, 2.63]). Stratified analyses showed significant associations between dual use and daily anxiety among Hispanic, non-Hispanic White, non-Hispanic Black, and non-Hispanic Asian adults. Of note, Hispanic males and females, non-Hispanic White males and females, Black females, non-Hispanic Asian males, and females of another race/ethnicity had higher odds of dual use, whereas Asian females had lower odds.
This study highlights heterogeneous relationships between daily anxiety and dual cigarette and EVP use at the intersection of sex, race, and ethnicity. Tailored interventions addressing persistent mental health symptoms are crucial for reducing tobacco use and associated disparities.
尽管吸烟率有所下降，但在美国，同时使用香烟和电子雾化产品（EVP）这种双重使用模式是令人担忧的尼古丁消费方式。焦虑是烟草使用的一个风险因素，可能导致双重使用模式；然而，每日焦虑症状与香烟和EVP双重使用之间的关联尚不清楚。本研究调查了每日焦虑症状与香烟和EVP双重使用之间的总体关联，以及按性别、种族和族裔划分的关联。
数据来自2020 - 2022年美国国家健康访谈调查（n = 83,544）。多项逻辑回归模型在对社会人口学因素、烟草使用、心理健康服务和药物特征进行调整后，检验了每日焦虑与当前单纯/双重使用香烟和EVP之间的关系。分层分析探讨了性别、种族和族裔的效应修正作用。
在样本中，13.0%的人报告有每日焦虑症状，1.3%的人报告同时使用香烟和EVP。每日焦虑与单纯使用香烟（优势比[OR]=1.54，95%置信区间[CI][1.42, 1.68]）、单纯使用EVP（OR = 1.44，95% CI [1.23, 1.68]）以及双重使用（OR = 2.16，95% CI [1.77, 2.63]）的几率增加相关。分层分析显示，西班牙裔、非西班牙裔白人、非西班牙裔黑人以及非西班牙裔亚裔成年人中，双重使用与每日焦虑之间存在显著关联。值得注意的是，西班牙裔男性和女性、非西班牙裔白人男性和女性、黑人女性、非西班牙裔亚裔男性以及其他种族/族裔的女性双重使用的几率较高，而亚裔女性的几率较低。
本研究强调了在性别、种族和族裔交叉点上，每日焦虑与香烟和EVP双重使用之间存在异质性关系。针对持续心理健康症状的量身定制干预措施对于减少烟草使用和相关差异至关重要。
