Klosterhalfen Stephanie, Hansen Julia, Hanewinkel Reiner
Institute of General Practice (ifam), Centre for Health and Society (chs), Addiction Research, and Clinical Epidemiology Unit, Medical Faculty and University Hospital Düsseldorf, Heinrich, Heine University Düsseldorf, Düsseldorf, Germany.
Institute for Therapy and Health Research, IFT-Nord, Kiel, Germany.
Tob Use Insights. 2025 Sep 3;18:1179173X251372794. doi: 10.1177/1179173X251372794. eCollection 2025.
Loneliness, a feeling of inadequate social relationships, is associated with behavioural health issues. This study examines the co-occurrence of loneliness and nicotine use (e-cigarettes, cigarettes and waterpipe (WP)) among adolescents aged 9-17 years in Germany.
Data were derived from the eighth wave of the "Präventionsradar", an annual school-based survey in Germany. The sample included 23 009 adolescents aged 9-17 years, from 107 schools and 1449 classes, who completed online questionnaires between November 2023 and February 2024. Prevalence rates and multilevel logistic regression models were used to assess associations between loneliness, measured using the three-item UCLA Loneliness Scale, and current nicotine use, adjusting for covariates (age, gender, social status, sensation seeking, school type).
Loneliness was reported by 31.5% of adolescents. It was associated with current cigarette use (OR 1.70, 95% CI 1.43-2.02), e-cigarette use (OR 1.59, 95% CI 1.38-1.83), WP use (OR 1.63, 95% CI 1.25-2.13), and any nicotine product use (OR 1.58, 95% CI 1.39-1.80). Early adolescents (11- to 14-year-olds) experiencing loneliness showed a higher risk of WP use (OR 1.90, 95% CI 1.16-3.13) and nicotine use (OR 1.39, 95% CI 1.07-1.80) compared to middle adolescents (15- to 17-year-olds).
Loneliness is prevalent and significantly linked to nicotine use among German adolescents, highlighting the need to address social factors in nicotine prevention efforts. The cross-sectional design limits causal inference.
孤独感，即一种社交关系不充分的感觉，与行为健康问题相关。本研究调查了德国9至17岁青少年中孤独感与尼古丁使用（电子烟、香烟和水烟）的共存情况。
数据来源于德国一项年度校内调查“预防雷达”的第八轮。样本包括来自107所学校和1449个班级的23009名9至17岁青少年，他们于2023年11月至2024年2月期间完成了在线问卷。患病率和多水平逻辑回归模型用于评估使用三项版加州大学洛杉矶分校孤独感量表测量的孤独感与当前尼古丁使用之间的关联，并对协变量（年龄、性别、社会地位、寻求刺激、学校类型）进行了调整。
31.5%的青少年报告有孤独感。孤独感与当前吸烟（比值比1.70，95%置信区间1.43 - 2.02）、电子烟使用（比值比1.59，95%置信区间1.38 - 1.83）、水烟使用（比值比1.63，95%置信区间1.25 - 2.13）以及任何尼古丁产品使用（比值比1.58，95%置信区间1.39 - 1.80）相关。与年龄较大的青少年（15至17岁）相比，感到孤独的年龄较小的青少年（11至14岁）使用水烟（比值比1.90，95%置信区间1.16 - 3.13）和尼古丁（比值比1.39，95%置信区间1.07 - 1.80）的风险更高。
孤独感在德国青少年中普遍存在，且与尼古丁使用显著相关，这凸显了在尼古丁预防工作中考虑社会因素的必要性。横断面设计限制了因果推断。
