A case-control study of association between e-cigarettes with smoking tendency in adolescents

Objective To investigate the influencing factors of smoking tendency of adolescents and to analyze the influence of e-cigarette on smoking tendency of teenagers and the possible interaction, to provide evidence for tobacco control measures. Methods Stratified multistage cluster probability sampling method was used to select 6 178 students from junior middle school, high school and vocational high school students in Shanghai for questionnaire survey from September to October 2019. Students with smoking tendency were taken as case group, adolescents with same sex and similar age (within 1 year) were mathed in 1 : 3 ratio. A total of 631 adolescents with smoking tendency and 1 870 non-smoking tendency were included in the study. Conditional Logistic regression was used to analyze the influencing factors and possible interactions. Results After adjusting gender, age and other cova- riates, conditional Logistic analysis results showed that the smoking tendency of middle school students was associated with factors such as their friends smoking, trying cigarettes and trying e-cigarettes. The OR value and 95% CI were 3.26(2.47–4.29), 5.90 (3.76–9.24), and 3.28(2.11–5.10), respectively. The interaction analysis results showed that the OR value and 95% CI of the multiplying interaction between friends smoking and trying e-cigarettes, trying smoking and trying e-cigarettes were 8.62(4.90–15.17) and 12.01(6.02–23.95), respectively. There was no additive interaction. Conclusion Tobacco control interventions, such as e-cigarette harm publicity and peer education, can help to change teenagers’ smoking tendency and further reduce their tobacco use rate. 【摘要】 目的 分析尝试电子烟对青少年吸烟倾向的影响以及可能存在的交互作用，为制定青少年控烟措施提供参考依 据。 方法 采用分层多阶段整群概率抽样法，于2019年9一10月抽取上海市初中、普髙、职髙的6 178名学生进行问卷调 査，将其中有吸烟倾向者作为病例组，以性别相同、年龄相差1岁以内作为配对因素，采用1 : 3个体匹配设计病例对照研 究，将病例组631名和对照组1 870名纳人研究。使用条件Logistic回归进行影响因素和交互作用分析。 结果 调整性别、 年龄等因素后，Logistic分析结果显示，中学生的吸烟倾向与好友吸烟、尝试吸烟、尝试电子烟等因素存在关联[ OR 值（ OR 值95%C/)分别为3.26(2.47~4.29)、5.90(3.76~9.24)、3.28(2.11~5.10)];交互作用分析结果显示，好友吸烟与尝试电子 烟、尝试吸烟与尝试电子烟均有相乘交互作用[ OR 值（ OR 值95%C/)分别为8.62(4.90~ 15.17)、12.01(6.02~23.95)]，无相 加交互作用。 结论 电子烟危害宣传、同伴教育等控烟干预措施有助于改变青少年的吸烟倾向，降低青少年的烟草使 用率。