Abstract：
OBJECTIVE: Electronic Nicotine Delivery System (ENDS) use and Waterpipe Tobacco Smoking (WTS) are reported to be a growing strain of tobacco epidemic among youth in the Arab world. Therefore, we aimed to: (1) estimate the regional prevalence of ENDS use among youth in 7 Arab countries and, (2) to explore the bidirectional relationship between ENDS use and WTS among Arab adolescents.
METHODS: We analyzed data from the World Health Organization Global Youth Tobacco Survey (GYTS 2014-2018) of 18,536 schoolchildren aged 12-16 from Iraq, Mauritania, Morocco, Oman, Qatar, Tunisia, and Yemen. The weighted prevalence was calculated to generate nationally representative estimates. Adjusted multilevel logistic regression models were conducted to assess the association between ENDS use and WTS.
RESULTS: The pooled weighted prevalence of ENDS use was 9.5%. Higher odds of ENDS use were significantly associated with WTS (AOR: 5.26, 95%CI: 4.28-6.46), smoking conventional cigarettes (AOR: 1.54, 95%CI: 1.23-1.94) and first tobacco use prior to the age of 12 (AOR: 1.40, 95%CI: 1.14-1.72). Females and children who were taught in school the dangers of tobacco had less odds of using ENDS.
CONCLUSIONS: WTS was associated with increased odds of ENDS use by >5 folds, and vice versa. Tobacco consumption at age younger than 12 years was associated with higher odds of ENDS use, but less odds of WTS. Females and those who were taught in school the dangers of tobacco were less likely to report ENDS use.
METHODS: We analyzed data from the World Health Organization Global Youth Tobacco Survey (GYTS 2014-2018) of 18,536 schoolchildren aged 12-16 from Iraq, Mauritania, Morocco, Oman, Qatar, Tunisia, and Yemen. The weighted prevalence was calculated to generate nationally representative estimates. Adjusted multilevel logistic regression models were conducted to assess the association between ENDS use and WTS.
RESULTS: The pooled weighted prevalence of ENDS use was 9.5%. Higher odds of ENDS use were significantly associated with WTS (AOR: 5.26, 95%CI: 4.28-6.46), smoking conventional cigarettes (AOR: 1.54, 95%CI: 1.23-1.94) and first tobacco use prior to the age of 12 (AOR: 1.40, 95%CI: 1.14-1.72). Females and children who were taught in school the dangers of tobacco had less odds of using ENDS.
CONCLUSIONS: WTS was associated with increased odds of ENDS use by >5 folds, and vice versa. Tobacco consumption at age younger than 12 years was associated with higher odds of ENDS use, but less odds of WTS. Females and those who were taught in school the dangers of tobacco were less likely to report ENDS use.
摘要：
目的：据报道，电子尼古丁输送系统（ENDS）的使用和水烟吸烟（WTS）是阿拉伯世界青年中烟草流行的一种趋势。因此,我们的目标是：(1)估计7个阿拉伯国家年轻人使用ENDS的地区患病率，(2)探讨阿拉伯青少年ENDS使用与WTS的双向关系。
方法：我们分析了世界卫生组织全球青年烟草调查（GYTS2014-2018）对来自伊拉克的18,536名12-16岁的学童的数据，毛里塔尼亚,摩洛哥,阿曼,卡塔尔,突尼斯,也门。计算加权患病率以产生具有全国代表性的估计值。使用调整后的多水平逻辑回归模型来评估ENDS使用与WTS之间的关联。
结果：使用ENDS的合并加权患病率为9.5%。使用ENDS的较高几率与WTS显着相关（AOR：5.26，95CI：4.28-6.46），吸烟常规香烟（AOR：1.54，95CI：1.23-1.94）和12岁之前首次吸烟（AOR：1.40，95CI：1.14-1.72）。在学校里被教导烟草危害的女性和儿童使用ENDS的可能性较小。
结论：WTS与ENDS使用几率增加>5倍相关，反之亦然。12岁以下的烟草消费与更高的ENDS使用几率相关，但WTS的可能性较小。女性和在学校接受过烟草危害的人不太可能报告使用ENDS。
方法：我们分析了世界卫生组织全球青年烟草调查（GYTS2014-2018）对来自伊拉克的18,536名12-16岁的学童的数据，毛里塔尼亚,摩洛哥,阿曼,卡塔尔,突尼斯,也门。计算加权患病率以产生具有全国代表性的估计值。使用调整后的多水平逻辑回归模型来评估ENDS使用与WTS之间的关联。
结果：使用ENDS的合并加权患病率为9.5%。使用ENDS的较高几率与WTS显着相关（AOR：5.26，95CI：4.28-6.46），吸烟常规香烟（AOR：1.54，95CI：1.23-1.94）和12岁之前首次吸烟（AOR：1.40，95CI：1.14-1.72）。在学校里被教导烟草危害的女性和儿童使用ENDS的可能性较小。
结论：WTS与ENDS使用几率增加>5倍相关，反之亦然。12岁以下的烟草消费与更高的ENDS使用几率相关，但WTS的可能性较小。女性和在学校接受过烟草危害的人不太可能报告使用ENDS。
