Changing patterns of cigarette and ENDS transitions in the USA: a multistate transition analysis of youth and adults in the PATH Study in 2015-2017 vs 2017-2019.

IF 4 2区 医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Tobacco Control Pub Date : 2024-09-25 DOI:10.1136/tc-2022-057905
Andrew F Brouwer, Jihyoun Jeon, Evelyn Jimenez-Mendoza, Stephanie R Land, Theodore R Holford, Abigail S Friedman, Jamie Tam, Ritesh Mistry, David T Levy, Rafael Meza
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Abstract

Introduction: It is unknown how recent changes in the tobacco product marketplace have impacted transitions in cigarette and electronic nicotine delivery system (ENDS) use.

Methods: A multistate transition model was applied to 24 242 adults and 12 067 youth in waves 2-4 (2015-2017) and 28 061 adults and 12 538 youth in waves 4 and 5 (2017-2019) of the Population Assessment of Tobacco and Health Study. Transition rates for initiation, cessation and product transitions were estimated in multivariable models, accounting for gender, age group, race/ethnicity and daily versus non-daily product use.

Results: Changes in ENDS initiation/relapse rates depended on age, including among adults. Among youth who had never established tobacco use, the 1-year probability of ENDS initiation increased after 2017 from 1.6% (95% CI 1.4% to 1.8%) to 3.8% (95% CI 3.4% to 4.2%). Persistence of ENDS-only use (ie, 1-year probability of continuing to use ENDS only) increased for youth from 40.7% (95% CI 34.4% to 46.9%) to 65.7% (95% CI 60.5% to 71.1%) and for adults from 57.8% (95% CI 54.4% to 61.3%) to 78.2% (95% CI 76.0% to 80.4%). Persistence of dual use similarly increased for youth from 48.3% (95% CI 37.4% to 59.2%) to 60.9% (95% CI 43.0% to 78.8%) and for adults from 40.1% (95% CI 37.0% to 43.2%) to 63.8% (95% CI 59.6% to 67.6%). Youth and young adults who used both products became more likely to transition to ENDS-only use, but middle-aged and older adults did not.

Conclusions: ENDS-only and dual use became more persistent. Middle-aged and older adults who used both products became less likely to transition to cigarette-only use but not more likely to discontinue cigarettes. Youth and young adults became more likely to transition to ENDS-only use.

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美国香烟和ENDS过渡模式的变化:2015年至2017年与2017年至2019年PATH研究中对青年和成年人的多州过渡分析。
引言:目前尚不清楚烟草产品市场最近的变化如何影响香烟和电子尼古丁输送系统(ENDS)使用的转变。方法:在烟草与健康研究的人口评估第2-4波(2015-2017年)中,对2422名成年人和12067名青年以及第4波和第5波(2017-2019年)中的280061名成年人和12338名青年应用了多州过渡模型。在多变量模型中估计了开始、停止和产品过渡的过渡率,考虑了性别、年龄组、种族/民族以及日常与非日常产品使用。结果:ENDS起始/复发率的变化取决于年龄,包括成年人。在从未确定吸烟的年轻人中,2017年后,开始使用ENDS的1年概率从1.6%(95%CI 1.4%至1.8%)增加到3.8%(95%CI 3.4%至4.2%)。青少年仅使用ENDS(即仅继续使用ENDS 1年概率)的持续性从40.7%(95%CI 34.4%至46.9%)增加到65.7%(95%CI 60.5%至71.1%),成人从57.8%(95%CI 54.4%至61.3%)增加到78.2%(95%CI 76.0%至80.4%)青少年的双重使用率从48.3%(95%CI 37.4%至59.2%)增加到60.9%(95%CI 43.0%至78.8%),成年人从40.1%(95%CI 3.70%至43.2%)增加到63.8%(95%CI 59.6%至67.6%)。使用这两种产品的青少年更有可能转为仅使用ENDS,但中老年人没有。结论:单纯ENDS和双重使用变得更加持久。使用这两种产品的中老年人不太可能过渡到只使用香烟,但不太可能停止吸烟。年轻人和年轻人更有可能过渡到仅使用ENDS。
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来源期刊
Tobacco Control
Tobacco Control 医学-公共卫生、环境卫生与职业卫生
CiteScore
9.10
自引率
26.90%
发文量
223
审稿时长
6-12 weeks
期刊介绍: Tobacco Control is an international peer-reviewed journal covering the nature and consequences of tobacco use worldwide; tobacco''s effects on population health, the economy, the environment, and society; efforts to prevent and control the global tobacco epidemic through population-level education and policy changes; the ethical dimensions of tobacco control policies; and the activities of the tobacco industry and its allies.
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