E-Cigarette Use among U.S. Adolescents and Young Adults: Longitudinal Associations with Tobacco Use and Health and Dimensions of Risk and Protection

美国青少年和年轻人的电子烟使用情况：与烟草使用和健康的纵向关联以及风险和保护的维度

• 批准号: 10586358
• 负责人: Rebecca J. Evans-Polce
• 金额: $ 36.93万
• 依托单位: UNIVERSITY OF MICHIGAN AT ANN ARBOR
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-12-15 至 2025-11-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10586358
• 关键词: Adolescent; Adolescent and Young Adult; Adult; Age; Biological Markers; Cigarette; Clinical; Complement; Cotinine; Data; Data Reporting; Dimensions; Education; Electronic cigarette; Ethnic Origin; Future; Generations; Goals; Health; Health Policy; Heterogeneity; High Prevalence; High School Student; Individual; Investigation; Knowledge; Longitudinal Studies; Measurement; Measures; Modeling; Monitor; Nicotine; Nitrosamines; Outcome; Patient Self-Report; Pattern; Policies; Policy Maker; Population Assessment of Tobacco and Health; Prevalence; Prevention; Public Health; Race; Reporting; Research; Research Methodology; Risk; Risk Factors; Role; Sampling; Sex Differences; Sex Orientation; Statistical Methods; Surveys; Symptoms; Time; Tobacco; Tobacco Use Cessation; Tobacco Use Disorder; Tobacco use; Vulnerable Populations; Work; cigarette smoking; clinical practice; clinically relevant; cohort; effective intervention; electronic cigarette use; epidemiology study; experience; health data; health knowledge; high risk; improved; longitudinal analysis; nicotine use; physical conditioning; prospective; protective factors; secondary analysis; sex; social; sociodemographics; substance use; tobacco products; twelfth grade; young adult

PROJECT SUMMARY/ABSTRACT One-third of U.S. adolescents and young adults (AYAs) report e-cigarette (EC) use, making it the leading nicotine/tobacco product used by AYAs. Most longitudinal studies of e-cigarette use only focus on short-term outcomes 1-3 years later, do not fully examine newer vs. older generation e-cigarette products, and do not consider potential differences by sex, age, race/ethnicity, educational attainment, or sexual orientation. Potential bias in e-cigarette estimates over time is not well understood. These gaps warrant longer-term prospective investigations with clinically relevant measures in diverse national samples of AYAs. This project will identify longitudinal trajectories of e-cigarette use and their relationships with cigarette smoking, other nicotine/tobacco products, other substance use, tobacco use disorder (TUD) symptoms, nicotine/tobacco cessation, and health consequences related to nicotine/tobacco use among U.S. AYAs. Our study aims to: (1) Compare state-of-the-art statistical approaches for reducing nonresponse bias in estimates of trajectories and survival models for EC use due to differential attrition, and evaluate the reporting bias associated with self- reports of EC use using biomarker data; (2) Examine the initiation of e-cigarette use and transitions with other nicotine/tobacco product use and other substance use in AYAs over 4- and 7-year time periods of longitudinal data; (3) Identify the trajectories of EC, cigarette, and other tobacco use and their longitudinal relationships with adverse health consequences (e.g., TUD symptoms, health problems) measured with survey and biomarker data in AYAs over 4- and 7-year time periods, and determine if trajectories or consequences differ by age, sex, race/ethnicity, education, sexual orientation, or newer vs. older e-cigarette products; and (4) Based on the Social Ecological Model, assess multiple levels of risk and protective factors (and interactions across levels) for EC use trajectories and their associations with other nicotine/tobacco use, tobacco cessation, and health consequences over 4- and 7-year time periods, and examine if EC use trajectories and their associations with other nicotine/tobacco use, tobacco cessation, and health consequences differ by age, sex, race/ethnicity, education, sexual orientation, or newer vs. older EC products. An experienced team will conduct secondary analyses of longitudinal data from the Monitoring the Future (MTF) and Population Assessment of Tobacco and Health (PATH) studies. These two epidemiological studies are the most recent and largest nationally representative longitudinal studies that allow for the identification of long-term trajectories and consequences of EC use among AYAs. This project will use longitudinal data from a nationally representative sample of 9,800 secondary students measured between 2014 and 2020 in the MTF study, and a prospective nationally representative sample of 13,651 adolescents (12-17 years), 9,802 young adults (18-25 years), and 22,506 adults (26 and older) measured across six waves in the PATH study (2013/2014-2020).

项目概要/摘要 三分之一的美国青少年和年轻人 (AYAs) 报告使用电子烟 (EC)，使其成为领先的 AYA 使用的尼古丁/烟草产品。大多数电子烟使用的纵向研究只关注短期 1-3年后的结果，不要全面检查新一代电子烟产品与老一代电子烟产品，并且不要 考虑性别、年龄、种族/民族、教育程度或性取向的潜在差异。 随着时间的推移，电子烟估计的潜在偏差尚不清楚。这些差距需要长期 在不同国家的 AYA 样本中采用临床相关措施进行前瞻性调查。本项目 将确定电子烟使用的纵向轨迹及其与吸烟、其他 尼古丁/烟草制品、其他物质使用、烟草使用障碍 (TUD) 症状、尼古丁/烟草 美国 AYA 中与尼古丁/烟草使用相关的戒烟和健康后果。我们的研究目的是：（1） 比较最先进的统计方法，以减少轨迹估计中的无响应偏差 由于差异消耗而使用 EC 的生存模型，并评估与自我相关的报告偏倚 使用生物标志物数据报告 EC 使用情况； (2) 检查电子烟使用的开始以及与其他产品的转变 4 年和 7 年纵向时期内 AYA 中尼古丁/烟草制品的使用和其他物质的使用 数据; (3) 确定电子烟、卷烟和其他烟草使用的轨迹及其纵向关系 通过调查和测量得出的不良健康后果（例如 TUD 症状、健康问题） AYA 中 4 年和 7 年时间段内的生物标志物数据，并确定轨迹或后果是否不同 按年龄、性别、种族/民族、教育程度、性取向或较新与较旧的电子烟产品；和（4） 基于社会生态模型，评估多个级别的风险和保护因素（以及相互作用） 跨级别）了解 EC 使用轨迹及其与其他尼古丁/烟草使用、戒烟的关联， 4 和 7 年时间段内的健康后果，并检查 EC 是否使用轨迹及其 与其他尼古丁/烟草使用、戒烟和健康后果的关联因年龄、性别、 种族/民族、教育程度、性取向或新旧 EC 产品。经验丰富的团队将进行 对来自监测未来（MTF）和人口评估的纵向数据进行二次分析 烟草与健康 (PATH) 研究。这两项流行病学研究是最新且规模最大的 具有全国代表性的纵向研究，可以确定长期轨迹和 AYA 中使用 EC 的后果。该项目将使用来自全国代表性的纵向数据 MTF 研究在 2014 年至 2020 年间对 9,800 名中学生进行了抽样调查，并进行了前瞻性研究 13,651 名青少年（12-17 岁）、9,802 名年轻人（18-25 岁）的全国代表性样本，以及 PATH 研究（2013/2014-2020 年）中，对 22,506 名成年人（26 岁及以上）进行了六波测量。