Mevawalla Areesh, Khalil Mujtaba, Rashid Zayed, Altaf Abdullah, Sarfraz Azza, Pawlik Timothy M
Department of Surgery, The Ohio State University Wexner Medical Center and James Comprehensive Cancer Center, Columbus, United States.
Tob Prev Cessat. 2025 Jul 25;11. doi: 10.18332/tpc/207098. eCollection 2025.
Tobacco use patterns have dramatically shifted, with electronic cigarettes (e-cigarettes) rapidly increasing in popularity despite uncertainty about their health impacts. This study examines adherence to preventive cancer screening guidelines among cigarette smokers, e-cigarette users, and non-smokers, addressing a critical gap in understanding how tobacco use influences engagement in preventive healthcare.
A total of 445132 adult respondents were queried from the 2022 Behavioral Risk Factor Surveillance System data. Analytic samples were restricted to age- and sex-eligible sub-cohorts for each cancer type, therefore including adults 50-75 years, women 50-74 years, and women 21-65 years for colon, breast and cervical screening, respectively. Within these analytic samples, we assessed the association between socioeconomic characteristics, smoking status, and screening adherence using weighted logistic regression, adjusted for relevant factors.
Screening adherence was lowest among cigarette smokers, intermediate among e-cigarette users, and highest among non-smokers. Compared to non-smokers, cigarette smokers had significantly lower odds of adhering to colorectal (AOR=0.75; 95% CI: 0.58-0.81), breast (AOR=0.57; 95% CI: 0.52-0.61), and cervical cancer screening (AOR=0.67; 95% CI: 0.62-0.72). E-cigarette users also showed reduced adherence to colorectal (AOR=0.90; 95% CI: 0.81-0.95) and breast cancer screening (AOR=0.75; 95% CI: 0.70-0.81) but not cervical cancer screening.
E-cigarette users exhibited suboptimal adherence to recommended cancer screenings, suggesting that perceptions of reduced risk associated with vaping do not translate into improved preventive healthcare behaviors. Targeted public health initiatives addressing risk misconceptions and healthcare access barriers are necessary to improve screening rates among all tobacco users.
烟草使用模式发生了巨大变化，尽管电子烟对健康的影响尚不确定，但电子烟的受欢迎程度正在迅速上升。本研究调查了吸烟者、电子烟使用者和非吸烟者对癌症预防筛查指南的遵循情况，填补了在理解烟草使用如何影响预防性医疗保健参与方面的关键空白。
从2022年行为风险因素监测系统数据中查询了总共445132名成年受访者。分析样本仅限于每种癌症类型符合年龄和性别的亚队列，因此分别包括50至75岁的成年人、50至74岁的女性以及21至65岁的女性用于结肠癌、乳腺癌和宫颈癌筛查。在这些分析样本中，我们使用加权逻辑回归评估社会经济特征、吸烟状况和筛查依从性之间的关联，并对相关因素进行了调整。
吸烟者的筛查依从性最低，电子烟使用者居中，非吸烟者最高。与非吸烟者相比，吸烟者坚持进行结肠直肠癌筛查（调整后比值比[AOR]=0.75；95%置信区间[CI]：0.58 - 0.81）、乳腺癌筛查（AOR=0.57；95% CI：0.52 - 0.61）和宫颈癌筛查（AOR=0.67；95% CI：0.62 - 0.72）的几率显著降低。电子烟使用者在结肠直肠癌筛查（AOR=0.90；95% CI：0.81 - 0.95）和乳腺癌筛查（AOR=0.75；95% CI：0.70 - 0.81）方面的依从性也有所降低，但在宫颈癌筛查方面没有降低。
电子烟使用者对推荐的癌症筛查表现出不理想的依从性，这表明认为吸电子烟风险较低的观念并未转化为更好的预防性医疗保健行为。有针对性的公共卫生举措，解决风险误解和医疗保健获取障碍，对于提高所有烟草使用者的筛查率是必要的。
