Changing patterns of nicotine product use and nicotine dependence among United States high-school students: The National Youth Tobacco Survey, 2014–2023

IF 5.3 1区医学 Q1 PSYCHIATRY

Addiction Pub Date : 2025-06-25 DOI:10.1111/add.70120

Sarah E. Jackson, Jamie Brown, Harry Tattan-Birch, Martin J. Jarvis

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Abstract

Background and aim

Concerns have been raised that e-cigarettes have created a new generation of people addicted to nicotine. This study aimed to measure changes in the proportion of US high-school students reporting symptoms of nicotine dependence over the past decade, in the context of changing patterns of nicotine product use.

Design

Repeat cross-sectional analyses of the 2014–2023 National Youth Tobacco Surveys.

Setting

United States of America.

Participants

107 968 high-school students (14–18y).

Measurements

Nicotine product use was categorised based on self-reported past-30-day use of cigarettes, other combustible tobacco, smokeless/non-combustible products and e-cigarettes. Nicotine dependence was operationalised as (a) strong past-30-day cravings to use tobacco and (b) wanting to use nicotine products within 30 minutes of waking.

Findings

Past-30-day use of any nicotine product decreased from 24.5% (95% confidence interval = 22.5%–26.6%) to 19.6% (16.8%–22.4%) between 2014 and 2017, increased sharply, reaching 31.4% (29.0%–33.7%) in 2019 (driven by an increase in e-cigarette use), then fell to the lowest level at 12.5% (10.9%–14.1%) by 2023. The proportion who reported symptoms of nicotine dependence was substantially lower, but followed a similar pattern of changes over time. For example, the proportion reporting strong cravings decreased from 7.8% (6.6%–9.0%) to 5.5% (4.3%–6.7%) between 2014 and 2017, increased to 7.9% (6.8%–9.0%) between 2017 and 2018 and remained stable up to 2020, then fell to the lowest level at 2.5% (1.9%–3.1%) by 2023. While dependence symptoms were consistently highest among cigarette users, they were increasingly prevalent among those using only e-cigarettes after 2017.

Conclusions

The sharp rise in the prevalence of nicotine product use (in particular, e-cigarettes) among US high-school students in the late 2010s was short-lived and was not accompanied by a sustained increase in the overall population burden of nicotine dependence. By 2023, both nicotine product use and nicotine dependence had reached historic lows. However, dependence symptoms increased over time among those using e-cigarettes only.

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美国高中生尼古丁产品使用和尼古丁依赖模式的变化：2014-2023年全国青少年烟草调查

背景和目的：人们越来越担心电子烟会让新一代的人对尼古丁上瘾。本研究旨在测量在过去十年中，在尼古丁产品使用模式变化的背景下，报告尼古丁依赖症状的美国高中生比例的变化。设计：对2014-2023年全国青少年烟草调查进行重复横断面分析。背景：美利坚合众国。对象：高中生107968人（14-18岁）。测量：根据自我报告的过去30天香烟、其他可燃烟草、无烟/不可燃产品和电子烟的使用情况，对尼古丁产品的使用进行了分类。尼古丁依赖被定义为(a)在过去30天内强烈地渴望使用烟草和(b)在醒来后30分钟内想要使用尼古丁产品。研究结果：在2014年至2017年期间，任何尼古丁产品的30天使用量从24.5%（95%置信区间= 22.5%-26.6%）下降到19.6%(16.8%-22.4%)，并急剧上升，在2019年达到31.4%(29.0%-33.7%)（受电子烟使用量增加的推动），然后降至最低水平12.5%（10.9%-14.1%）。报告有尼古丁依赖症状的比例大大降低，但随着时间的推移，变化的模式相似。例如，报告强烈渴望的比例在2014年至2017年期间从7.8%（6.6%-9.0%）下降到5.5%(4.3%-6.7%)，在2017年至2018年期间上升到7.9%(6.8%-9.0%)，并保持稳定到2020年，然后在2023年降至最低水平2.5%（1.9%-3.1%）。尽管依赖症状在香烟使用者中一直是最高的，但在2017年之后，它们在只使用电子烟的人群中越来越普遍。结论：2010年代末，美国高中生中尼古丁产品（特别是电子烟）使用率的急剧上升是短暂的，并没有伴随着尼古丁依赖的总体人口负担的持续增加。到2023年，尼古丁产品的使用和尼古丁依赖都达到了历史低点。然而，随着时间的推移，那些只使用电子烟的人的依赖症状会增加。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Addiction 医学-精神病学

CiteScore

10.80

自引率

6.70%

发文量

319

审稿时长

3 months

期刊介绍： Addiction publishes peer-reviewed research reports on pharmacological and behavioural addictions, bringing together research conducted within many different disciplines. Its goal is to serve international and interdisciplinary scientific and clinical communication, to strengthen links between science and policy, and to stimulate and enhance the quality of debate. We seek submissions that are not only technically competent but are also original and contain information or ideas of fresh interest to our international readership. We seek to serve low- and middle-income (LAMI) countries as well as more economically developed countries. Addiction’s scope spans human experimental, epidemiological, social science, historical, clinical and policy research relating to addiction, primarily but not exclusively in the areas of psychoactive substance use and/or gambling. In addition to original research, the journal features editorials, commentaries, reviews, letters, and book reviews.