Louisiana M Sanchez, Junhan Cho, Alyssa F Harlow, Richard A Miech, Steven Sussman, Hongying D Dai, Abigail Adjei, Dae-Hee Han, Ming Li, Leah Meza, Adam M Leventhal, Dayoung Bae
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引用次数: 0
Abstract
Policy Points Menthol-flavored e-cigarettes are disproportionately used by youth who co-use other substances; allowing menthol sales may undermine efforts to reduce poly-tobacco and poly-substance use. Fruit/ice-fruit flavors are most common among lower-risk youth (those not engaged in other substance use), and banning these flavors could help prevent nicotine initiation. Because nearly all youth who vape use non-tobacco-flavored e-cigarettes, comprehensive policies that eliminate access to all non-tobacco-flavored e-cigarettes, including menthol, may be more effective than selective bans. Stronger enforcement and broader flavor restrictions could help prevent initiation and reduce sustained use, particularly among youth who co-use menthol-flavored e-cigarettes and other substances.
Context: The specific nontobacco e-cigarette flavors used by US youth who exclusively vape e-cigarettes compared with youth who engage in poly-tobacco or poly-substance use can help identify the populations most likely to be impacted by e-cigarette flavor policies. This study examines correlations between e-cigarette flavor use and past 30-day tobacco and substance use among US youth who vape.
Methods: We analyzed the Monitoring the Future survey data (2021-2023), a nationally representative annual study of US eighth, tenth, and 12th graders. Among 14,675 participants who vaped nicotine in the past year, we assessed their most frequently used e-cigarette flavor: fruit/ice-fruit, menthol, mint, sweet, tobacco, or unflavored. Log-binomial regression models estimated adjusted prevalence ratios (APRs) for correlations between e-cigarette flavor use and past 30-day tobacco and substance use, adjusting for sociodemographic characteristics and e-cigarette use.
Findings: Few youth predominately vaped tobacco-flavored (1.3%) or unflavored (3.6%) e-cigarettes, regardless of whether they did or did not use other tobacco products or nontobacco substances. Menthol-flavored (12.1%) e-cigarette use was correlated with past 30-day cigarette (APR 1.53, 95% CI 1.29-1.81), smokeless tobacco (APR 1.53, 95% CI 1.24-1.89), cigars/hookah tobacco products (APR 1.51, 95% CI 1.13-2.02), and alcohol (APR 1.16, 95% CI 1.02-1.32) use. In contrast, fruit/ice-fruit-flavored (72.3%) e-cigarettes were less commonly used among youth who smoked cigarettes (APR 0.83, 95% CI 0.76-0.90), used smokeless tobacco (APR 0.83, 95% CI 0.75-0.91), or reported noncannabis illicit drug use (APR 0.89, 95% CI 0.80-0.98).
Conclusions: Closing federal regulatory loopholes and implementing state and local bans on all non-tobacco-flavored e-cigarettes may support efforts to reduce youth nicotine uptake. Policies that limit access and sales to menthol-flavored e-cigarettes could be particularly relevant for youth at risk of poly-tobacco or poly-substance use.
青少年与其他物质同时使用薄荷味电子烟的比例过高;允许薄荷醇销售可能会破坏减少多种烟草和多种物质使用的努力。水果/冰果口味在低风险青少年(那些没有其他物质使用的人)中最常见,禁止这些口味可以帮助防止尼古丁的开始。因为几乎所有吸电子烟的年轻人都使用非烟草味电子烟,所以全面禁止使用所有非烟草味电子烟(包括薄荷醇)的政策可能比选择性禁令更有效。更强有力的执法和更广泛的口味限制可以帮助防止开始和减少持续使用,特别是在共同使用薄荷味电子烟和其他物质的年轻人中。背景:与使用多种烟草或多种物质的年轻人相比,专门吸电子烟的美国年轻人使用的特定非烟草电子烟口味可以帮助确定最有可能受到电子烟口味政策影响的人群。这项研究调查了美国年轻人使用电子烟口味与过去30天烟草和物质使用之间的相关性。方法:我们分析了监测未来调查数据(2021-2023),这是一项具有全国代表性的美国八年级、十年级和十二年级学生的年度研究。在过去一年中吸过尼古丁的14675名参与者中,我们评估了他们最常用的电子烟口味:水果/冰果、薄荷、薄荷、甜味、烟草或无味。对数二项回归模型估计了电子烟香精使用与过去30天烟草和物质使用之间相关性的调整患病率(APRs),并根据社会人口统计学特征和电子烟使用进行了调整。研究结果:很少有年轻人主要吸烟草味(1.3%)或无味(3.6%)电子烟,无论他们是否使用其他烟草制品或非烟草物质。薄荷味(12.1%)电子烟的使用与过去30天的香烟(APR 1.53, 95% CI 1.29-1.81)、无烟烟草(APR 1.53, 95% CI 1.24-1.89)、雪茄/水烟烟草制品(APR 1.51, 95% CI 1.13-2.02)和酒精(APR 1.16, 95% CI 1.02-1.32)的使用相关。相比之下,在吸烟(APR 0.83, 95% CI 0.76-0.90)、使用无烟烟草(APR 0.83, 95% CI 0.75-0.91)或报告使用非大麻非法药物(APR 0.89, 95% CI 0.80-0.98)的青少年中,水果/冰果味(72.3%)电子烟的使用频率较低。结论:填补联邦监管漏洞,实施州和地方对所有非烟草味电子烟的禁令,可能有助于减少青少年对尼古丁的摄入。限制获取和销售薄荷味电子烟的政策可能与面临多种烟草或多种物质使用风险的青少年特别相关。
期刊介绍:
The Milbank Quarterly is devoted to scholarly analysis of significant issues in health and health care policy. It presents original research, policy analysis, and commentary from academics, clinicians, and policymakers. The in-depth, multidisciplinary approach of the journal permits contributors to explore fully the social origins of health in our society and to examine in detail the implications of different health policies. Topics addressed in The Milbank Quarterly include the impact of social factors on health, prevention, allocation of health care resources, legal and ethical issues in health policy, health and health care administration, and the organization and financing of health care.