Yusuff Adebayo Adebisi, Don Eliseo Lucero-Prisno, Isaac Olushola Ogunkola
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引用次数: 0
Abstract
The comparative health implications of e-cigarette use versus traditional cigarette smoking remain a critical focus in public health research. This cross-sectional study examined differences in self-rated general health between exclusive e-cigarette users and exclusive cigarette smokers, using data from the 2017-2019 Scottish Health Survey. A total of 2484 adults (aged 16 and above) were included and categorized as exclusive e-cigarette users (n = 565) or exclusive cigarette smokers (n = 1919). Self-rated health was assessed using a single-item measure with five response categories: "very bad," "bad," "fair," "good," and "very good". Generalized ordinal logistic regression models were used to estimate the association between nicotine product use and self-rated health, adjusting for age, sex, Scottish Index of Multiple Deprivation, marital status, ethnicity, alcohol consumption frequency, physical activity, presence of longstanding physical or mental health conditions, and age of smoking initiation. In the fully adjusted model, exclusive e-cigarette users had higher odds of reporting better self-rated health compared to exclusive cigarette smokers overall (OR = 1.26, 95% CI 1.05-1.51, p = 0.012). A graded relationship was also observed in the fully adjusted model, with progressively lower odds of reporting better self-rated health as smoking intensity increased, using exclusive e-cigarette users as the reference group. Heavy smokers (≥ 20 cigarettes/day) had the lowest odds of reporting better self-rated health (OR = 0.63, 95% CI 0.49-0.80, p < 0.001), followed by moderate smokers (10 to < 20 cigarettes/day) (OR = 0.81, 95% CI 0.66-0.99, p = 0.047). In contrast, light smokers (< 10 cigarettes/day) showed no significant difference in self-rated health compared to exclusive e-cigarette users (OR = 0.94, 95% CI 0.75-1.18, p = 0.614). These findings indicate that exclusive e-cigarette use is associated with better self-rated health compared to exclusive cigarette smoking, particularly among moderate and heavy smokers. Additional analyses revealed no significant differences in self-rated health among exclusive e-cigarette users based on prior smoking history (OR = 0.94, 95% CI 0.43-2.08, p = 0.882) or among exclusive cigarette smokers based on prior e-cigarette use (OR = 0.87, 95% CI 0.69-1.09, p = 0.219). These findings suggest that prior use is unlikely to explain the observed association between exclusive e-cigarette use and better self-rated health compared to exclusive cigarette smoking. Given the subjective nature of self-rated health, these findings should be interpreted with caution. Future longitudinal studies incorporating objective health measures are essential to assess the long-term impacts of e-cigarette use and inform evidence-based harm reduction policies.
使用电子烟与传统吸烟对健康的比较影响仍然是公共卫生研究的一个关键焦点。这项横断面研究使用2017-2019年苏格兰健康调查的数据,研究了专用电子烟使用者和专用香烟吸烟者之间自评总体健康状况的差异。共有2484名成年人(16岁及以上)被纳入研究,并被归类为纯电子烟使用者(n = 565)或纯吸烟者(n = 1919)。自我评估的健康状况使用单项测量方法进行评估,有五个回答类别:“非常差”、“差”、“一般”、“好”和“非常好”。在调整了年龄、性别、苏格兰多重剥夺指数(Scottish Index of Multiple Deprivation)、婚姻状况、种族、饮酒频率、身体活动、长期存在的身体或精神健康状况以及开始吸烟年龄等因素后,使用广义有序逻辑回归模型来估计尼古丁产品使用与自评健康之间的关系。在完全调整后的模型中,纯电子烟使用者比纯卷烟使用者报告的自我评价健康状况更好的几率更高(OR = 1.26, 95% CI 1.05-1.51, p = 0.012)。在完全调整的模型中也观察到一种分级关系,使用纯电子烟使用者作为参照组,随着吸烟强度的增加,报告更好的自我评价健康的几率逐渐降低。重度吸烟者(≥20支/天)报告自我评价健康状况较好的几率最低(OR = 0.63, 95% CI 0.49-0.80, p
期刊介绍:
Internal and Emergency Medicine (IEM) is an independent, international, English-language, peer-reviewed journal designed for internists and emergency physicians. IEM publishes a variety of manuscript types including Original investigations, Review articles, Letters to the Editor, Editorials and Commentaries. Occasionally IEM accepts unsolicited Reviews, Commentaries or Editorials. The journal is divided into three sections, i.e., Internal Medicine, Emergency Medicine and Clinical Evidence and Health Technology Assessment, with three separate editorial boards. In the Internal Medicine section, invited Case records and Physical examinations, devoted to underlining the role of a clinical approach in selected clinical cases, are also published. The Emergency Medicine section will include a Morbidity and Mortality Report and an Airway Forum concerning the management of difficult airway problems. As far as Critical Care is becoming an integral part of Emergency Medicine, a new sub-section will report the literature that concerns the interface not only for the care of the critical patient in the Emergency Department, but also in the Intensive Care Unit. Finally, in the Clinical Evidence and Health Technology Assessment section brief discussions of topics of evidence-based medicine (Cochrane’s corner) and Research updates are published. IEM encourages letters of rebuttal and criticism of published articles. Topics of interest include all subjects that relate to the science and practice of Internal and Emergency Medicine.