在美国青少年中，完全使用和双重使用香烟和电子尼古丁输送系统与哮喘之间的纵向关联
2023/09/21
摘要
背景：在过去的十年里,青少年的电子尼古丁传递系统(ENDS)的使用大大增加, 但它对哮喘等慢性呼吸系统疾病的影响尚不完全清楚。
方法：我们利用离散时间风险模型分析了烟草与健康人群评估研究(Population Assessment of Tobacco and Health Study)第1～5波(2013—2019年)的数据，分析了在基线时12～17岁青少年中，随时间变化的烟草制品使用与新发哮喘诊断之间的关联。我们将随时间变化的暴露变量滞后一个波，并根据当前使用状态(过去30天内的1+天)对受访者进行分类:从未或非当前、只吸烟、只使用ENDS，以及同时使用香烟和ENDS。我们还控制了社会人口统计学(年龄、性别、种族/民族、父母教育)和其他危险因素(城市/农村环境、二手烟暴露、家庭可燃烟草使用、体重指数)。
结果：在基线中,超过一半的分析样本(n=9,141)是15-17岁(50.4%),女性(50.2%)和非西班牙裔白人(55.3%)。完全吸烟的青少年在随访时发生确诊哮喘的风险显著高于目前不使用香烟或ENDS的青少年(校正风险比（aHR）:1.68,95%可信区间（CI）:1.21-2.32)，但完全使用ENDS的青少年(aHR:1.25, 95% CI: 0.77-2.04)或同时使用香烟的青少年(aHR:1.54, 95% CI:0.92-2.57)没有这一情况。
讨论：在青少年中，短期完全吸烟与5年随访期间新发确诊哮喘的风险较高相关。我们没有发现完全的ENDS或双重使用与新发确诊哮喘之间的确凿证据。
Longitudinal Association Between Exclusive and Dual Use of Cigarettes and Electronic Nicotine Delivery Systems and Asthma Among U.S. Adolescents
Akash Patel, Steven Cook, Delvon T Mattingly, Geoffrey D Barnes, Douglas A Arenberg, David T Levy, Rafael Meza, Nancy L Fleischer, Jana L Hirschtick
Abstract
BACKGROUND:Electronic Nicotine Delivery Systems (ENDS) use among adolescents has increased greatly over the past decade, but its impact on chronic respiratory health conditions, like asthma, is not fully understood.
METHODS: We examined data from Waves 1-5 (2013-2019) of the Population Assessment of Tobacco and Health Study using discrete time hazard models to analyze the association between time-varying tobacco product use and incident diagnosed asthma among adolescents aged 12-17 years at baseline. We lagged the time-varying exposure variable by one wave and categorized respondents by current use status (1+ days in the past 30 days): never or non-current, exclusive cigarette, exclusive ENDS, and dual cigarette and ENDS use. We also controlled for sociodemographic (age, sex, race/ethnicity, parental education) and other risk factors (urban/rural setting, secondhand smoke exposure, household combustible tobacco use, body mass index).
RESULTS: At baseline, over half the analytic sample (n = 9,141) was 15-17 years old (50.4%), female (50.2%), and non-Hispanic White (55.3%). Adolescents who exclusively smoked cigarettes had a statistically significant higher risk of incident diagnosed asthma at follow-up (adjusted Hazard Ratio (aHR): 1.68, 95% confidence interval (CI): 1.21-2.32) compared to those not currently using cigarettes or ENDS, but adolescents using ENDS exclusively (aHR: 1.25, 95% CI: 0.77-2.04) or in combination with cigarettes (aHR: 1.54, 95% CI: 0.92-2.57) did not.
DISCUSSIONS: Short-term exclusive cigarette use was associated with a higher risk of incident diagnosed asthma over five years of follow-up among adolescents. We did not find conclusive evidence for an association between exclusive ENDS or dual use and incident diagnosed asthma.
背景：在过去的十年里,青少年的电子尼古丁传递系统(ENDS)的使用大大增加, 但它对哮喘等慢性呼吸系统疾病的影响尚不完全清楚。
方法：我们利用离散时间风险模型分析了烟草与健康人群评估研究(Population Assessment of Tobacco and Health Study)第1～5波(2013—2019年)的数据，分析了在基线时12～17岁青少年中，随时间变化的烟草制品使用与新发哮喘诊断之间的关联。我们将随时间变化的暴露变量滞后一个波，并根据当前使用状态(过去30天内的1+天)对受访者进行分类:从未或非当前、只吸烟、只使用ENDS，以及同时使用香烟和ENDS。我们还控制了社会人口统计学(年龄、性别、种族/民族、父母教育)和其他危险因素(城市/农村环境、二手烟暴露、家庭可燃烟草使用、体重指数)。
结果：在基线中,超过一半的分析样本(n=9,141)是15-17岁(50.4%),女性(50.2%)和非西班牙裔白人(55.3%)。完全吸烟的青少年在随访时发生确诊哮喘的风险显著高于目前不使用香烟或ENDS的青少年(校正风险比（aHR）:1.68,95%可信区间（CI）:1.21-2.32)，但完全使用ENDS的青少年(aHR:1.25, 95% CI: 0.77-2.04)或同时使用香烟的青少年(aHR:1.54, 95% CI:0.92-2.57)没有这一情况。
讨论：在青少年中，短期完全吸烟与5年随访期间新发确诊哮喘的风险较高相关。我们没有发现完全的ENDS或双重使用与新发确诊哮喘之间的确凿证据。
（中日友好医院呼吸与危重症医学科 李春晓 摘译 林江涛 审校）
（J Adolesc Health 2023 Sep;73(3):437-444DOI: 10.1016/j.jadohealth.2023.04.009）
（J Adolesc Health 2023 Sep;73(3):437-444DOI: 10.1016/j.jadohealth.2023.04.009）
Longitudinal Association Between Exclusive and Dual Use of Cigarettes and Electronic Nicotine Delivery Systems and Asthma Among U.S. Adolescents
Akash Patel, Steven Cook, Delvon T Mattingly, Geoffrey D Barnes, Douglas A Arenberg, David T Levy, Rafael Meza, Nancy L Fleischer, Jana L Hirschtick
Abstract
BACKGROUND:Electronic Nicotine Delivery Systems (ENDS) use among adolescents has increased greatly over the past decade, but its impact on chronic respiratory health conditions, like asthma, is not fully understood.
METHODS: We examined data from Waves 1-5 (2013-2019) of the Population Assessment of Tobacco and Health Study using discrete time hazard models to analyze the association between time-varying tobacco product use and incident diagnosed asthma among adolescents aged 12-17 years at baseline. We lagged the time-varying exposure variable by one wave and categorized respondents by current use status (1+ days in the past 30 days): never or non-current, exclusive cigarette, exclusive ENDS, and dual cigarette and ENDS use. We also controlled for sociodemographic (age, sex, race/ethnicity, parental education) and other risk factors (urban/rural setting, secondhand smoke exposure, household combustible tobacco use, body mass index).
RESULTS: At baseline, over half the analytic sample (n = 9,141) was 15-17 years old (50.4%), female (50.2%), and non-Hispanic White (55.3%). Adolescents who exclusively smoked cigarettes had a statistically significant higher risk of incident diagnosed asthma at follow-up (adjusted Hazard Ratio (aHR): 1.68, 95% confidence interval (CI): 1.21-2.32) compared to those not currently using cigarettes or ENDS, but adolescents using ENDS exclusively (aHR: 1.25, 95% CI: 0.77-2.04) or in combination with cigarettes (aHR: 1.54, 95% CI: 0.92-2.57) did not.
DISCUSSIONS: Short-term exclusive cigarette use was associated with a higher risk of incident diagnosed asthma over five years of follow-up among adolescents. We did not find conclusive evidence for an association between exclusive ENDS or dual use and incident diagnosed asthma.
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英格兰的哮喘住院率与热暴露：2002-2019 年期间的病例交叉研究
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英国儿童及青少年中支气管哮喘诊断、学龄前喘息诊断及哮喘急性发作最新趋势：SABINA Jr研究
