Objective

This study reports the prospectively estimated age of initiation of susceptibility to, ever, past 30-day, and fairly regular hookah use.

Design

Secondary data analyses of the first four waves (2013–2017) of the PATH study, a nationally representative longitudinal cohort study of US youth (ages 12–17).

Methods

Youth who were never hookah users at their first wave of participation were identified (n = 16,678; N = 31,136,834). Four outcomes were analyzed, age of first report of: (i) susceptibility to use, (ii) ever use, (iii) past 30-day use, and (iv) fairly regular hookah use. The age of hookah initiation of each outcome was estimated. Weighted interval censoring survival analyses and Cox regression models were conducted to estimate the age of initiation of each hookah use outcome, and to estimate differences in age of initiation by sex and by race, respectively.

Results

Around 11% of youth were classified as susceptible to hookah use by 13 years of age, 8% reported initiating ever hookah use by age 17, almost 10% reported initiating past 30-day hookah use by age 19, and 3% reported initiating fairly regular hookah use by age 20. Females and Hispanics were at higher risk of becoming susceptible to and ever hookah use at earlier ages compared to males and Non-Hispanic White youth.

Conclusion

Education, communication campaigns, and proven culturally targeted tobacco interventions that reach youth at ages before they first become susceptible or start using hookah use are needed to prevent the onset of hookah use among vulnerable youth.

中文翻译：

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年轻人中开始使用水烟的年龄的前瞻性估计：烟草与健康人口评估（PATH）研究波1-4的发现（2013-2017年）

目的

这项研究报告了过去30天和相当定期使用水烟的易感性开始的预期估计年龄。

设计

PATH研究的前四次浪潮（2013-2017年）的二次数据分析，该研究是美国青少年（12-17岁）的全国代表性纵向队列研究。

方法

确定了在第一波参与时从未使用过水烟的年轻人（n = 16,678； N = 31,136,834）。分析了以下四个结果，即首次报告的年龄：（i）使用易感性，（ii）曾经使用，（iii）过去30天使用，以及（iv）定期使用水烟。估计每个结果的水烟启动年龄。进行了加权间隔审查生存分析和Cox回归模型，以估计每个水烟使用结果的起始年龄，并分别估计性别和种族的起始年龄差异。

结果

大约11％的年轻人在13岁之前被归类为易使用水烟壶，8％的人报告说在17岁时开始使用水烟壶，近10％的人报告在19岁时开始使用30天以上的水烟壶，3％的人报告会公平使用与年龄段的男性和非西班牙裔白人青年相比，女性和西班牙裔人在更早的年龄易受水烟使用的风险更高。

结论

需要开展教育，宣传运动，以及经过验证的针对文化的烟草干预措施，这些干预措施要在青年人首次变得易受感染或开始使用水烟之前的年龄就达到他们的年龄，以防止弱势青年开始使用水烟。