Introduction

Financial strain is associated with an increased likelihood of cigarette smoking, but less is known about its association with electronic nicotine delivery systems (ENDS) use. This study examined longitudinal associations of financial strain with ENDS use behaviors among young adults.

Methods

We analyzed in 2020 four waves (2013-2018) of the Population Assessment of Tobacco and Health, a nationally representative longitudinal study. A total of 5,740 U.S. young adults (aged 18-24 years at baseline) had matched data for all four waves. We used generalized linear mixed modeling which accounts for correlations between repeated measures. Weighted logistic regressions assessed the association between financial strain and three different types of ENDS use behaviors (i.e., everyday, some-day, and experimental use), adjusting for major confounders including poverty, mental health symptoms, and other substance use behaviors.

Results

Frequency and proportion of everyday ENDS use showed a linear increase over time whereas some-day and experimental uses showed quadratic trends, increasing with a peak at Wave 2 and then decreasing over time. Financial strain prospectively predicted some-day (adjusted odds ratio [AOR] = 1.32; 95% CI = 1.03-1.69) and experimental (AOR = 1.25; 95% CI = 1.02-1.52) ENDS use, but not everyday use.

Conclusions

The findings of the current study indicate the need for distinctly different approaches for non-daily ENDS users from daily users. Our findings further suggest that ENDS use prevention and cessation efforts should consider financial strain of young adults particularly for non-daily users to thwart them from progressing towards nicotine dependence and long-term use.

中文翻译：

---

美国年轻人中的财务压力和尼古丁电子输送系统的使用：纵向面板分析，2013-2018年

介绍

财务压力与吸烟的可能性增加有关，但人们对其与电子尼古丁传送系统（ENDS）的使用的关联知之甚少。这项研究调查了年轻人中财务压力与ENDS使用行为的纵向关联。

方法

我们在2020年分析了全国代表性的纵向研究《烟草与健康人口评估》的四波（2013-2018）。共有5740名美国年轻人（基线年龄在18-24岁之间）获得了所有四个波的匹配数据。我们使用了广义线性混合模型，该模型说明了重复测量之间的相关性。加权逻辑回归评估了财务压力与三种不同类型的ENDS使用行为（即每天，某天和实验使用）之间的关联，并针对主要混杂因素进行了调整，包括贫困，心理健康症状和其他物质使用行为。

结果

日常使用ENDS的频率和比例随时间呈线性增加，而一天和实验用途则呈二次趋势，在Wave 2处出现峰值，然后随时间下降。财务压力可以预测某天（调整后的优势比[AOR] = 1.32； 95％CI = 1.03-1.69）和实验性数据（AOR = 1.25； 95％CI = 1.02-1.52），但不是每天使用。

结论

当前研究的结果表明，对于非日常使用ENDS的用户和日常使用的用户，需要截然不同的方法。我们的发现进一步表明，ENDS的使用预防和戒烟工作应考虑年轻人的经济压力，尤其是对于非日常使用者，以阻止他们朝着尼古丁依赖和长期使用的方向发展。