澳大利亚 12 至 17 岁青少年吸食电子烟与随后开始吸烟之间的关系：利用 5114 名青少年的横断面回忆数据进行的回顾性队列分析。

IF 2.6 3区医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Australian and New Zealand Journal of Public Health Pub Date : 2024-10-01 DOI:10.1016/j.anzjph.2024.100173

Sam Egger , Michael David , Christina Watts , Anita Dessaix , Alecia Brooks , Emily Jenkinson , Paul Grogan , Marianne Weber , Qingwei Luo , Becky Freeman

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引用次数: 0

摘要

本研究的目的是估算澳大利亚青少年吸食电子烟与随后开始吸烟之间的关系，并探讨以往研究中的设计和分析方法的影响。方法我们对5114名14-17岁澳大利亚青少年的横断面数据进行了回顾性队列分析，他们回忆了12-17岁期间吸烟和开始吸食电子烟的信息。分析结果为开始吸烟，采用负二叉回归法估算作为时变暴露的吸食状况（吸食过与从未吸食过）的发病率比（IRR）。我们还使用以往研究中未考虑电子烟暴露时变性质的方法进行了重新分析。结果对参与者（n=5114）进行了 20478 人年的回顾性随访。在对社会人口学变量以及吸食电子烟和吸烟的共同责任的替代措施进行调整后，曾经吸食电子烟者的吸烟率是从未吸食者的近5倍（IRR=4.9；95%置信区间：[3.9，6.0]，p<0.001），年龄越小，IRR越高。结论对照分析表明，吸食电子烟明显增加了12至17岁澳大利亚青少年随后开始吸烟的风险，其中12、13和14岁的青少年承担的风险升高的负担过重，令人震惊。此外，由于方法上的差异，其他研究可能低估了吸食电子烟导致未来吸烟的相对风险。

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The association between vaping and subsequent initiation of cigarette smoking in young Australians from age 12 to 17 years: a retrospective cohort analysis using cross-sectional recall data from 5114 adolescents

Objective

The objective of this study was to estimate the association between vaping and subsequent initiation of smoking among Australian adolescents and explore the impact of design and analytical methods in previous studies.

Methods

We conducted a retrospective cohort analysis of cross-sectional data from 5114 Australian adolescents aged 14–17 recalling information on smoking and vaping initiation from age 12 to 17. The outcome was smoking initiation, analysed with negative-binomial regression to estimate incidence rate ratios (IRRs) for vape status (ever-vaped vs never-vaped) as a time-varying exposure. We also re-analysed using the methods of previous studies not accounting for the time-varying nature of e-cigarette exposure.

Results

Participants (n=5114) were retrospectively followed for 20478 person-years. After adjusting for socio-demographic variables and proxy measures of common liabilities for vaping and smoking, the rate of smoking initiation for those who ever-vaped was nearly 5 times that of those who never-vaped (IRR=4.9; 95% confidence interval: [3.9, 6.0], p<0.001), with IRRs considerably higher at younger ages. Not accounting for the time-varying nature of e-cigarette exposure in re-analysis attenuated the estimated IRR by 44%.

Conclusions

Controlled analyses indicate that vaping markedly increases the risk of subsequent smoking initiation among Australian adolescents from age 12 to 17, with those aged 12, 13, and 14 bearing an alarmingly disproportionate burden of the elevated risk. Additionally, the relative risk of future smoking due to vaping may have been underestimated in other studies due to methodological differences.

Implications for public health

Our findings highlight the need for public health interventions and strict e-cigarette access laws.

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来源期刊

Australian and New Zealand Journal of Public Health 医学-公共卫生、环境卫生与职业卫生

CiteScore

4.20

自引率

5.70%

发文量

121

审稿时长

6-12 weeks

期刊介绍： The Australian and New Zealand Journal of Public Health (ANZJPH) is concerned with public health issues. The research reported includes formal epidemiological inquiries into the correlates and causes of diseases and health-related behaviour, analyses of public policy affecting health and disease, and detailed studies of the cultures and social structures within which health and illness exist. The Journal is multidisciplinary and aims to publish methodologically sound research from any of the academic disciplines that constitute public health.