The impact of e-cigarette use on adolescent uptake and persistence of conventional smoking: Who is most vulnerable?

电子烟的使用对青少年吸食和坚持传统吸烟的影响：谁最脆弱？

• 批准号: 9175970
• 负责人: JANET E AUDRAIN-MCGOVERN
• 金额: $ 61.88万
• 依托单位: UNIVERSITY OF PENNSYLVANIA
• 依托单位国家: 美国
• 财政年份: 2016
• 资助国家: 美国
• 起止时间: 2016-07-01 至 2021-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9175970
• 关键词: 14 year old; 18 year old; Address; Adolescence; Adolescent; Age; Alcohol consumption; Anxiety; Attention deficit hyperactivity disorder; Characteristics; Cigarette; Data; Dependence; Development; Electronic cigarette; Environmental Risk Factor; Expectancy; Flavoring; Fostering; Individual; Intervention; Longitudinal Studies; Measures; Mediating; Mental Depression; Modeling; Nicotine; Nicotine Dependence; Outcome; Parents; Pathway interactions; Pattern; Predisposition; Prevalence; Psychological reinforcement; Public Health; Reporting; Research; Risk; Risk Factors; Severities; Smoke; Smoking; Subgroup; Symptoms; Time; Tobacco use; Toxin; Youth; adolescent smoking; catalyst; cigarette smoking; cohort; density; evidence base; expectation; marijuana use; peer; preference; prospective; response; risk perception; smoking cessation; uptake

PROJECT SUMMARY The growing popularity of electronic cigarette (e-cig) use among adolescents is a cause for public health and regulatory concern. Current use of e-cigs among adolescents has increased more than 10-fold from 2011 to 2014 (1.5% to 17%). Although an e-cig delivers lower levels of known toxins than a combustible cigarette, both deliver nicotine, potentially fostering cross-product use through dependence on nicotine. Research indicates that the majority of adolescents who use e-cigs also use combustible cigarettes (i.e., dual use). While concerns have been raised regarding the potential for e-cigs to erode decades of adolescent smoking control efforts by promoting the uptake and persistence of combustible cigarette smoking, existing data cannot fully justify or allay these concerns. Prospective, longitudinal studies are urgently needed to address four vital questions. One, do e-cigs act as a catalyst for regular combustible cigarette smoking for youth who may not have otherwise smoked and if so, why? Two, do e-cigs contribute to the persistence of regular combustible cigarette smoking, possibly by allowing adolescents to substitute e-cigs for combustible cigarettes in smoke-free situations? Three, which adolescents are most likely to progress to regular e-cig use and then to dual use? Four, are there subgroups of adolescents with unique longitudinal patterns of single use and dual use (e.g., adolescents who only use e-cigs, adolescents who only smoke cigarettes, duals users who vary in their pathway to dual use) and what are the characteristics of adolescents who have these patterns of use? We propose to address these critical gaps in the evidence base by following a prospective, longitudinal cohort of 2,000 adolescents from mid (age 14 years) to late adolescence (age 18 years), measuring e-cig use, cigarette smoking, and individual and environmental risk factors for use every 6 months (8 waves total). Outcomes include the odds of progression to regular use (combustible, e-cig, and dual), smoking persistence, and trajectories of use. The proposed approach will enable us to create a comprehensive model of the developmental relationship between e-cig use and combustible cigarette smoking among adolescents, to identify unique patterns of use, and to determine the factors that drive single and dual use. A greater understanding of e-cig use and its relationship to combustible cigarette smoking will be fundamental to inform evidenced-based public health efforts and e-cig regulatory actions to protect youth from nicotine dependence and from smoking.

项目摘要 青少年中电子烟（E-cig）使用的日益普及是公共卫生和 监管问题。从2011年开始，当前在青少年中使用电子烟超过10倍 2014年（1.5％至17％）。尽管电子烟比可燃的香烟可提供较低的已知毒素水平，但 两者都通过依赖尼古丁提供尼古丁，可能促进交叉产物使用。研究 表明大多数使用电子烟的青少年也使用可燃香烟（即双重用途）。 尽管对电子烟的潜力侵蚀了几十年的青少年吸烟的可能性提出了担忧 通过促进可燃香烟吸烟的吸收和持久性来控制工作，现有数据不能 完全证明或减轻这些关注。迫切需要进行前瞻性，纵向研究来解决四个 重要的问题。第一，do e-wigs充当定期可燃香烟吸烟的催化剂，为年轻人吸烟 没有其他烟，如果是，为什么？二，do e-wigs有助于常规的持久性 可燃的香烟吸烟，可能是通过允许青少年代替电子烟来可燃香烟 在无烟的情况下？第三，青少年最有可能发展到常规的电子烟，然后 双重用途？四，是否有独特的纵向模式的青少年亚组 使用（例如，仅使用电子烟的青少年，只抽烟的青少年，双重用户 他们的双重使用途径）以及具有这些使用模式的青少年的特征是什么？ 我们建议通过遵循前瞻性的纵向队列来解决证据基础中的这些关键差距 从中期（14岁）到青春期（18岁）的2,000名青少年，测量电子烟的使用， 吸烟，以及每6个月使用一次的个人和环境风险因素（总共8波）。 结局包括对定期使用的进展几率（可燃，电子烟和双重），吸烟持久性， 和使用轨迹。提出的方法将使我们能够创建一个全面的模型 电子烟的使用与青少年吸烟可燃香烟之间的发展关系， 确定独特的使用模式，并确定驱动单一和双重使用的因素。更大 了解电子烟的使用及其与可燃香烟吸烟的关系将是基本的 告知基于历史的公共卫生工作和电子烟监管行动，以保护青年免受 尼古丁依赖和吸烟。