青少年電子煙使用與吸菸意圖或吸菸行為之關聯性：系統性文獻回顧

Association of e-cigarette use with smoking intentions and behaviors among adolescents: a systematic review

10.6288/TJPH.201904_38(2).107136

賴鼎富(Ting-Fu Lai)；林倩宇(Chien-Yu Lin)；廖邕(Yung Liao)

青少年 ； 理性行動論 ； 電子煙 ； 吸菸意圖 ； 吸菸行為 ； adolescent ； Theory of Reasoned Action ； e-cigarette ； smoking intention ； smoking behavior

台灣公共衛生雜誌

38卷2期（2019 / 04 / 01）

124 - 138

繁體中文

世界衛生組織指出，吸菸為全球主要的健康危險因子。近年來電子煙在青少年族群中的使用率逐漸提升，而青少年電子煙使用與其未來吸菸意圖及行為的關聯仍有爭論。本文以PubMed、PsycINFO、CINAHL資料庫、與華藝線上圖書館，系統性回顧2014年1月至2018年2月，以中、英文發表的青少年電子煙使用與其未來吸菸意圖及行為相關研究，共納入18篇符合納入規範的文獻。現有研究多來自於美國，且多為橫斷性設計，僅有少數追蹤不超過一年的縱貫性研究。我們依循部分理性行動論的架構，將研究結果歸納成「電子煙使用與吸菸意圖之關聯」與「電子煙使用與吸菸行為之關聯」兩大主軸。結果指出，青少年的電子煙使用與其吸菸意圖、吸菸行為及吸菸的數量與頻率均呈正相關。建議未來研究採用長期的縱貫性設計，以利於確認其因果關聯，作為公共衛生研究與實務之參考。

The World Health Organization reported that smoking is a primary health risk factor. The prevalence of e-cigarette use in adolescents has increased recently. However, the association of e-cigarette use with smoking intentions and behaviors is unconfirmed. Through PubMed, PsycINFO, CINAHL, and Airiti Library, this study systematically reviewed studies published in English or Chinese language that have examined the association of adolescent's e-cigarette use with smoking intentions and behaviors from January 2014 to February 2018. We identified 18 empirical studies satisfying the respective criteria. Most of the studies had cross-sectional designs and were from the United States; only a few longitudinal studies had follow-up periods of less than 1 year. Based on the Theory of Reasoned Action, this systematic review provided some evidence of positive associations between e-cigarette use and smoking intentions, smoking behavior, and smoking frequency among adolescents. Future research must investigate the association of e-cigarette use with smoking-related behaviors by using longitudinal designs with long-term follow-ups to determine the respective causality for informing subsequent policymaking and research.

1. Azagba, S,Baskerville, NB,Foley, K(2017).Susceptibility to cigarette smoking among middle and high school e-cigarette users in Canada.Prev Med,103,14-19.
2. Azagba, S,Wolfson, M(2018).E-cigarette use and quantity of cigarette smoking among adolescent cigarette smokers: a finite mixture model analysis.Drug Alcohol Depend,185,33-39.
3. Barrington-Trimis, JL,Berhane, K,Unger, JB(2016).The e-cigarette social environment, e-cigarette use, and susceptibility to cigarette smoking.J Adolesc Health,59,75-80.
4. Best, C,Haseen, F,Currie, D(2018).Relationship between trying an electronic cigarette and subsequent cigarette experimentation in Scottish adolescents: a cohort study.Tob Control,27,373-378.
5. Brewer, JL,Blake, AJ,Rankin, SA,Douglass, LW(1999).Theory of Reasoned Action predicts milk consumption in women.J Am Diet Assoc,99,39-44.
6. Brock, B,Choi, K,Boyle, RG,Moilanen, M,Schillo, BA(2016).Tobacco product prices before and after a statewide tobacco tax increase.Tob Control,25,166-173.
7. Bunnell, RE,Agaku, IT,Arrazola, RA(2015).Intentions to smoke cigarettes among never-smoking US middle and high school electronic cigarette users: National Youth Tobacco Survey, 2011-2013.Nicotine Tob Res,17,228-235.
8. Centers for Disease Control and Prevention(2014).The Health Consequences of Smoking - 50 Years of Progress: A Report of the Surgeon General.Atlanta, GA:Centers for Disease Control and Prevention.
9. Chen, HJ,Balan, S,Price, RK(2012).Association of contextual factors with drug use and binge drinking among White, Native American, and Mixed-Race adolescents in the general population.J Youth Adolesc,41,1426-1441.
10. Demissie, Z,Everett Jones, S,Clayton, HB,King, BA(2017).Adolescent risk behaviors and use of electronic vapor products and cigarettes.Pediatrics,139(2),e20162921.
11. Didarloo, A,Shojaeizadeh, D,Ardebili, HE,Niknami, S,Hajizadeh, E,Alizadeh, M(2011).Factors influencing physical activity behavior among Iranian women with type 2 diabetes using the extended theory of reasoned action.Diabetes Metab J,35,513-522.
12. Ekelund, U,Steene-Johannessen, J,Brown, WJ(2016).Does physical activity attenuate, or even eliminate, the detrimental association of sitting time with mortality? A harmonised meta-analysis of data from more than 1 million men and women.Lancet,388,1302-1310.
13. El Dib, R,Suzumura, EA,Akl, EA(2017).Electronic nicotine delivery systems and/or electronic non-nicotine delivery systems for tobacco smoking cessation or reduction: a systematic review and meta-analysis.BMJ Open,7,e012680.
14. Etter, JF,Zather, E,Svensson, S(2013).Analysis of refill liquids for electronic cigarettes.Addiction,108,1671-1679.
15. Faber, T,Been, JV,Reiss, IK,Mackenbach, JP,Sheikh, A(2016).Smoke-free legislation and child health.NPJ Prim Care Respir Med,26,16067.
16. Farsalinos, KE,Kistler, KA,Gillman, G,Voudris, V(2015).Evaluation of electronic cigarette liquids and aerosol for the presence of selected inhalation toxins.Nicotine Tob Res,17,168-174.
17. Feigin, VL,Roth, GA,Naghavi, M(2016).Global burden of stroke and risk factors in 188 countries, during 1990-2013: a systematic analysis for the Global Burden of Disease Study 2013.Lancet Neurol,15,913-924.
18. Fishbein, M,Ajzen, I(1975).Belief, Attitude, Intention, and Behavior: An Introduction to Theory and Research.Reading, MA:Addison-Wesley.
19. GBD 2015 Risk Factors Collaborators(2016).Global, regional, and national comparative risk assessment of 79 behavioural, environmental and occupational, and metabolic risks or clusters of risks, 1990-2015: a systematic analysis for the Global Burden of Disease Study 2015.Lancet,388,1659-1724.
20. Goniewicz, ML,Leigh, NJ,Gawron, M(2016).Dual use of electronic and tobacco cigarettes among adolescents: a cross-sectional study in Poland.Int J Public Health,61,189-197.
21. Gorukanti, A,Delucchi, K,Ling, P,Fisher-Travis, R,Halpern-Felsher, B(2017).Adolescents’ attitudes towards e-cigarette ingredients, safety, addictive properties, social norms, and regulation.Prev Med,94,65-71.
22. Grana, R,Benowitz, N,Glantz, SA(2014).E-cigarettes: a scientific review.Circulation,129,1972-1986.
23. Hahn, J,Monakhova, YB,Hengen, J(2014).Electronic cigarettes: overview of chemical composition and exposure estimation.Tob Induc Dis,12,23.
24. Hamari, AK,Toljamo, TI,Kinnula, VL,Nieminen, PA(2013).Dual use of cigarettes and Swedish snuff (snus) among young adults in Northern Finland.Eur J Public Health,23,768-771.
25. Hamer, M,Ford, T,Stamatakis, E,Dockray, S,Batty, GD(2011).Objectively measured secondhand smoke exposure and mental health in children: evidence from the Scottish Health Survey.Arch Pediatr Adolesc Med,165,326-331.
26. Hamer, M,Stamatakis, E,Batty, GD(2010).Objectively assessed secondhand smoke exposure and mental health in adults: cross-sectional and prospective evidence from the Scottish Health Survey.Arch Gen Psychiatry,67,850-855.
27. Hoffman, AC,Evans, SE(2013).Abuse potential of non-nicotine tobacco smoke components: acetaldehyde, nornicotine, cotinine, and anabasine.Nicotine Tob Res,15,622-632.
28. Huang, SL,Lin, IF,Chen, CY,Tsai, TI(2013).Impact of tobacco control policies on adolescent smoking: findings from the Global Youth Tobacco Survey in Taiwan.Addiction,108,1829-1835.
29. Jiang, TH,Cheng, LM,Hawkins, MA(2018).A study of regulatory policies and relevant issues concerning electronic cigarette use in Taiwan.Int J Health Plann Manage,33,e119-e130.
30. Keating D. Parliament adopts new EU tobacco rules. Available at: https://www.politico.eu/article/parliament-adopts-new-eu-tobacco-rules/. Accessed July 2, 2018.
31. Kmet, LM,Lee, RC,Cook, LS(2004).Standard Quality Assessment Criteria for Evaluating Primary Research Papers from a Variety of Fields.Edmonton, CA:Alberta Heritage Foundation for Medical Research=AHFMR.
32. Lanza, ST,Russell, MA,Braymiller, JL(2017).Emergence of electronic cigarette use in US adolescents and the link to traditional cigarette use.Addict Behav,67,38-43.
33. Lee, HW,Park, SH,Weng, MW(2018).E-cigarette smoke damages DNA and reduces repair activity in mouse lung, heart, and bladder as well as in human lung and bladder cells.Proc Natl Acad Sci U S A,115,E1560-E1569.
34. Lee, S,Kimm, H,Yun, JE,Jee, SH(2011).Public health challenges of electronic cigarettes in South Korea.J Prev Med Public Health,44,235-241.
35. Leventhal, AM,Strong, DR,Kirkpatrick, MG(2015).Association of electronic cigarette use with initiation of combustible tobacco product smoking in early adolescence.JAMA,314,700-707.
36. Lorenzo-Blanco, EI,Schwartz, SJ,Unger, JB(2016).Alcohol use among recent immigrant Latino/a youth: acculturation, gender, and the Theory of Reasoned Action.Ethn Health,21,609-627.
37. Martínez-Sánchez, JM,Ballbè, M,Fu, M(2014).Attitudes towards electronic cigarettes regulation in indoor workplaces and selected public and private places: a population-based cross-sectional study.PLoS One,9,e114256.
38. McCabe, SE,West, BT,McCabe, VV(2018).Associations between early onset of e-cigarette use and cigarette smoking and other substance use among US adolescents: a national study.Nicotine Tob Res,20,923-930.
39. McRobbie, H,Bullen, C,Hartmann-Boyce, J,Hajek, P(2014).Electronic cigarettes for smoking cessation and reduction.Cochrane Database Syst Rev,12,CD010216.
40. Miech, R,Patrick, ME,O’Malley, PM,Johnston, LD(2017).E-cigarette use as a predictor of cigarette smoking: results from a 1-year follow-up of a national sample of 12th grade students.Tob Control,26,e106-e111.
41. Morgenstern, M,Nies, A,Goecke, M,Hanewinkel, R(2018).E-cigarettes and the use of conventional cigarettes. a cohort study in 10th grade students in Germany.Dtsch Arztebl Int,115,243-248.
42. Park, JY,Seo, DC,Lin, HC(2016).E-cigarette use and intention to initiate or quit smoking among US youths.Am J Public Health,106,672-678.
43. Pénzes, M,Foley, KL,Nădășan, V,Paulik, E,Ábrám, Z,Urbán, R(2018).Bidirectional associations of e-cigarette, conventional cigarette and waterpipe experimentation among adolescents: a cross-lagged model.Addict Behav,80,59-64.
44. Primack, BA,Soneji, S,Stoolmiller, M,Fine, MJ,Sargent, JD(2015).Progression to traditional cigarette smoking after electronic cigarette use among US adolescents and young adults.JAMA Pediatr,169,1018-1023.
45. Ramoa, CP,Hiler, MM,Spindle, TR(2016).Electronic cigarette nicotine delivery can exceed that of combustible cigarettes: a preliminary report.Tob Control,25,e6-e9.
46. Randolph, ME,Pinkerton, SD,Somlai, AM(2009).Seriously mentally ill women's safer sex behaviors and the theory of reasoned action.Health Educ Behav,36,948-958.
47. Rom, O,Pecorelli, A,Valacchi, G,Reznick, AZ(2015).Are E-cigarettes a safe and good alternative to cigarette smoking?.Ann N Y Acad Sci,1340,65-74.
48. Schroeder, MJ,Hoffman, AC(2014).Electronic cigarettes and nicotine clinical pharmacology.Tob Control,23(Suppl 2),ii30-ii35.
49. Secades-Villa, R,Garcia-Rodriguez, O,Jin, CJ,Wang, S,Blanco, C(2015).Probability and predictors of the cannabis gateway effect: a national study.Int J Drug Policy,26,135-142.
50. Shaikh, A,Ansari, HT,Ahmad, Z(2017).Knowledge and attitude of teenagers towards electronic cigarettes in Karachi, Pakistan.Cureus,9,e1468.
51. Soneji, S,Barrington-Trimis, JL,Wills, TA(2017).Association between initial use of e-cigarettes and subsequent cigarette smoking among adolescents and young adults: a systematic review and meta-analysis.JAMA Pediatr,171,788-797.
52. Stephens, WE(2018).Comparing the cancer potencies of emissions from vapourised nicotine products including e-cigarettes with those of tobacco smoke.Tobacco Control,27,10-17.
53. Syrjala, AM,Niskanen, MC,Knuuttila, ML(2002).The theory of reasoned action in describing tooth brushing, dental caries and diabetes adherence among diabetic patients.J Clin Periodontol,29,427-32.
54. Treur, JL,Rozema, AD,Mathijssen, JJP,van, Oers, H,Vink, JM(2018).E-cigarette and waterpipe use in two adolescent cohorts: cross-sectional and longitudinal associations with conventional cigarette smoking.Eur J Epidemiol,33,323-334.
55. U.S. Department of Health and Human Services. FDA's deeming regulations for E-cigarettes, cigars, and all other tobacco products. Available at: https://www.fda.gov/tobaccoproducts/labeling/rulesregulationsguidance/ucm394909.htm. Accessed July 2, 2018.
56. UK Legislation. The tobacco and related products regulations 2016. Available at: http://www.legislation.gov.uk/uksi/2016/507/contents/made. Accessed July 2, 2018.
57. US Department of Health and Human Services(2006).The Health Consequences of Involuntary Exposure to Tobacco Smoke: A Report of the Surgeon General.Atlanta, GA:US Department of Health and Human Services, Centers for Disease Control and Prevention, Coordinating Center for Health Promotion, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health.
58. Van Hurck, MM,Nuyts, PAW,Monshouwer, K,Kunst, AE,Kuipers, MAG(2018).Impact of removing point-of-sale tobacco displays on smoking behaviour among adolescents in Europe: a quasi-experimental study.Tob Control,2018,pii:tobaccocontrol.
59. Wang, MP,Ho, SY,Leung, LT,Lam, TH(2015).Electronic cigarette use and its association with smoking in Hong Kong Chinese adolescents.Addict Behav,50,124-127.
60. WHO(2006).Rules of Procedure of the Conference of the Parties to the WHO Framework Convention on Tobacco Control.Geneva:WHO.
61. Wills, TA,Knight, R,Sargent, JD,Gibbons, FX,Pagano, I,Williams, RJ(2017).Longitudinal study of e-cigarette use and onset of cigarette smoking among high school students in Hawaii.Tob Control,26,34-39.
62. Wills, TA,Sargent, JD,Knight, R,Pagano, I,Gibbons, FX(2016).E-cigarette use and willingness to smoke: a sample of adolescent non-smokers.Tob Control,25,e52-e59.
63. Yoong, SL,Stockings, E,Chai, LK(2018).Prevalence of electronic nicotine delivery systems (ENDS) use among youth globally: a systematic review and meta-analysis of country level data.Aust N Z J Public Health,42,303-308.
64. 洪嘉翎, CL(2017)。台北=Taipei，台北醫學大學醫療暨生物科技法律研究所=Graduate Institute of Health and Biotechnology Law, Taipei Medical University。
65. 埃裡克．費爾德曼, EA,柴月, Y(2015)。芻議中國電子煙監管。中國煙草學報，21，76-85。
66. 衛生福利部：菸害防制法。http://law.moj.gov.tw/LawClass/LawAll.aspx?PCode=L0070021。引用2018/07/02。 Ministry of Health and Welfare, R.O.C. (Taiwan). Tobacco Hazards Prevention Act. Available at: http://law.moj.gov.tw/LawClass/LawAll.aspx?PCode=L0070021. Accessed July 2, 2018.
67. 衛生福利部食品藥物管理署：藥事法。https://law.moj.gov.tw/LawClass/LawAll.aspx?PCode=L0030001。引用2018/07/02。 Food and Drug Administration, Ministry of Health and Welfare, R.O.C. (Taiwan). Pharmaceutical Affairs Act. Available at: https://law.moj.gov.tw/LawClass/LawAll.aspx?PCode=L0030001. Accessed July 2, 2018.
68. 衛生福利部國民健康署, Ministry of Health and Welfare, R.O.C. (Taiwan)(2017).2016台灣菸害防制年報.台北=Taipei:衛生福利部國民健康署=Health Promotion Administration, Ministry of Health and Welfare, R.O.C. (Taiwan).
69. 衛生福利部國民健康署：青少年吸菸行為調查。台北衛生福利部國民健康署，2017。 Health Promotion Administration, Ministry of Health and Welfare, R.O.C. (Taiwan). Global Youth Tobacco Survey (GYTS). Taipei: Health Promotion Administration, Ministry of Health and Welfare, R.O.C. (Taiwan), 2017 [In Chinese]
70. 蘇郁淳, YC(2017)。論我國菸害防制法草案針對電子煙管制於技術性貿易障礙協定下之適法性。經貿法訊，217，26-44。

1. 劉冠儀(Kuan-Yi Liu);廖容瑜(Jung-Yu Liao);張文琪(Wen-Chi Chang);劉芳怡(Fang-Yi Liu);呂莉婷(Li-Ting Lu)(2021)。「青春無菸煙」校園電子煙危害防制教學活動之成效初探。教育科學研究期刊。66(4)。167-182。