背景:中国年轻人中烟草/传统香烟(CC)和电子香烟(EC)使用量的增加已成为越来越多的公共卫生问题。这是第一项大规模研究,以比较CC和EC的使用对中国顺式异性恋,性和性别少数(SGM)青年人群的非自杀性自我伤害(NSSI)和自杀风险的影响。
目的:本研究考察了中国青年NSSI和自杀的CC和EC风险,并比较了SGM和顺式异性恋青年NSSI和自杀的风险在多大程度上受到CC和EC的使用和依赖性的影响。
方法:2021年共有89,342名中国参与者完成了横断面自我报告调查。社会人口统计信息,性取向,性别认同,CC和EC用法,CC和EC依赖性,并评估了自杀和NSSI的风险。对非正态分布连续变量和分类变量进行了Mann-WhitneyU检验和卡方检验,分别。多元线性回归模型用于检验CC和EC使用率以及CC和EC依赖性对NSSI和自杀性的影响,以及CC和EC使用率以及CC和EC依赖性对NSSI和自杀性的交互作用。
结果:SGM参与者的CC使用率(P<.001)和依赖性(P<.001)的患病率低于其顺式异性恋者。然而,SGM参与者的EC使用率(P=.03)和EC依赖性(P<.001)高于顺式异性恋者.多元线性回归模型显示,CC依赖性和EC依赖性对NSSI和自杀性具有独特的影响(CCs:B=0.02,P<.001;B=0.09,P<.001;ECs:B=0.05,P<.001;B=0.14,P<.001)。(1)CC用法和群体类型对NSSI和自杀性的交互作用(分别为B=0.34,P<.001;B=0.24,P=.03)以及双重用法和群体类型对NSSI和自杀性的交互作用(分别为B=0.54,P<.001;B=0.84,P<.001)是显着的,(2)NSSI的CC依赖性和组类型显著(B=0.07,P<.001),(3)EC依赖性和群体类型对NSSI和自杀率的影响显着(分别为B=0.04,P<.001;B=0.09,P<.001)。EC使用和组类型对NSSI和自杀性(分别为B=0.15,P=.12;B=0.33,P=.32)之间以及CC依赖性和组类型对自杀性(B=-0.01,P=.72)之间未观察到显着的交互作用。
结论:我们的研究表明,SGM和顺性异性恋青年之间NSSI和自杀风险的组间差异与CC和EC使用有关。这些发现有助于顺式异性恋和SGM人群中有关CC和EC的文献不断增加。必须在社会层面作出协调一致的努力,以遏制欧共体行业和媒体报道的积极营销战略,并最大限度地提高教育运动对青年群体中欧共体预防和干预的影响。
BACKGROUND: The increase in tobacco/conventional cigarette (CC) and electronic cigarette (EC) usage among Chinese youth has become a growing public health concern. This is the first large-scale study to compare the impact of CC and EC usage on risk for nonsuicidal self-injury (NSSI) and suicidality in cis-heterosexual and sexual and gender minority (SGM) youth populations in
China.
OBJECTIVE: This study examines the CC and EC risks for NSSI and suicidality among Chinese youth and compares the extent to which SGM and cis-heterosexual youth\'s risks for NSSI and suicidality are influenced by their CC and EC usage and dependence.
METHODS: A total of 89,342 Chinese participants completed a cross-sectional self-report survey in 2021. Sociodemographic information, sexual orientations, gender identities, CC and EC usage, CC and EC dependence, and risks for suicidality and NSSI were assessed. The Mann-Whitney U test and chi-square test were performed for nonnormally distributed continuous variables and categorical variables, respectively. The multivariable linear regression model was used to examine both the influence of CC and EC usage and CC and EC dependence on NSSI and suicidality as well as the interaction effects of CC and EC usage and CC and EC dependence on NSSI and suicidality by group.
RESULTS: The prevalence of CC usage (P<.001) and dependence (P<.001) among SGM participants was lower than that among their cis-heterosexual counterparts. However, the prevalence of EC usage (P=.03) and EC dependence (P<.001) among SGM participants was higher than that among their cis-heterosexual counterparts. The multivariable linear regression model showed that CC dependence and EC dependence had a unique effect on NSSI and suicidality (CCs: B=0.02, P<.001; B=0.09, P<.001; ECs: B=0.05, P<.001; B=0.14, P<.001, respectively). The interaction effects of (1) CC usage and group type on NSSI and suicidality (B=0.34, P<.001; B=0.24, P=.03, respectively) and dual usage and group type on NSSI and suicidality (B=0.54, P<.001; B=0.84, P<.001, respectively) were significant, (2) CC dependence and group type on NSSI were significant (B=0.07, P<.001), and (3) EC dependence and group type on NSSI and suicidality were significant (B=0.04, P<.001; B=0.09, P<.001, respectively). No significant interaction effect was observed between EC usage and group type on NSSI and suicidality (B=0.15, P=.12; B=0.33, P=.32, respectively) and between CC dependence and group type on suicidality (B=-0.01, P=.72).
CONCLUSIONS: Our study shows evidence of intergroup differences in NSSI and suicidality risks between SGM and cis-heterosexual youth related to CC and EC usage. These findings contribute to the growing literature on CC and EC in cis-heterosexual and SGM populations. Concerted efforts are necessary at a societal level to curb the aggressive marketing strategies of the EC industry and media coverage and to maximize the impact of educational campaigns on EC prevention and intervention among the youth population.