台灣青少年與成人電子煙使用盛行率從2014年到2018年的增加：與變化有關的社會人口特徵、其他物質使用、及憂鬱情緒

Abstract

背景及目的 近年來，電子煙的使用盛行率逐漸上升，然而，較少研究探討電子煙在不同社會人口學特徵、其他物質使用與憂鬱階層中的使用趨勢。這項研究旨在 (1)比較2014年和2018年兩波全國性調查中電子煙使用盛行率的變化， (2)並檢查在社會人口學特性、其他物質使用和憂鬱程度中不同層級電子煙盛行率的改變，以及 (3)檢查過去一年使用電子煙的受訪者對電子煙的尼古丁依賴情形。 方法 數據資料來自2014年和2018年台灣全國物質使用調查，分別有17,837名受訪者 (完訪率為62.2%，共有4,445名青少年和13,392名成人)和18,626名受訪者 (完訪率為64.6%，共有3,598名青少年和15,028名成人)。該調查之目標族群為12-64歲國民，受訪者會在自己家裡，使用平板電腦匿名完成計算機輔助的自我訪談。兩波調查內容均包括有關社會人口學特性、合法和非法物質使用、尼古丁依賴量表 (FTND)、酒精使用疾患確認檢測 (AUDIT)、濫用藥物確認試驗 (DAST)以及流行病學研究中心憂鬱量表 (CES-D)等資訊。 結果 使用電子煙的終生盛行率從2014年的2% (青少年：0.8%，成人：2.2%)上升至2018年的4.2% (青少年：2.5%，成人：4.3%)，增加2.2% (年輕人增加1.7%，成人增加2.1%)。在社會人口學特性的不同階層中，大部分階層的電子煙使用盛行率有顯著增加，而且較高盛行率階層的絕對差有較多的增加。在其他物質使用的階層中，電子煙終生盛行率在青少年的絕對差的增加都比成人大，例如，青少年香煙使用者的電子煙盛行率增加26.2％，檳榔使用者增加24.7％，而成人電子煙盛行率分別增加7.4％和6.1％。中度至高度憂鬱者的電子煙使用盛行率增加更多，其中，青少年增加1.7％，成人增加4.8％；而青少年憂鬱得分較低者增加1.7％，成人增加2.1％。 結論 電子煙盛行率在2014年至2018年期間整體增加一倍，並且在社會人口學特徵、物質使用和憂鬱程度的所有階層中都有增加。其中，男性、年齡介於15至17歲以及年輕成人有顯著的電子煙使用盛行率改變。在青少年與成人中，抽菸、喝酒、嚼食檳榔、尼古丁依賴的兩個分層以及問題飲酒的兩個分層中都有顯著的盛行率改變。此外，在過去一年使用電子煙者中，有兩成的人達到中高度尼古丁依賴。

Introduction: The prevalence of e-cigarettes use has been found to increase in recent years. However, few studies have examined the trends of e-cigarette use and the correlation of these trend with social demographics, other substances use and depression. We aimed to (1) compare the change in the prevalence of e-cigarette use in two waves of national surveys in 2014 and 2018, (2) examine the change across strata over sociodemographic features, use of other substances, and depression, and (3) examine the nicotine dependence among past year e-cigarette users in 2018. Method: Participants from the 2014 national survey of 17,837 individuals (a response rate of 62.2%, with 4445 adolescents and 13392adults) and the 2018 national survey of 18,626 individuals (a response rate of 64.6%, with 3598 adolescents and 15028 adults), aged 12 to 64 year, completed anonymously a computer-assisted self-interview. The questionnaire contained items on sociodemographic features, e-cigarettes use, other substance use, problematic use of tobacco (via Fagerström Test for Nicotine Dependence, FTND), alcohol (via Alcohol Use Disorders Identification Test, AUDIT), and other drugs (via Drug Abuse Screening Test, DAST), and depression (via Center for Epidemiological Studies Depression Scale, CES-D), among others. Results: Lifetime prevalence of e-cigarettes use increased from 2.0% in 2014 (0.8% for adolescents and 2.2% for adults) to 4.2% in 2018 (2.5% for adolescents and 4.3% for adults), with an increase of 2.2% (1.7% for adolescents and 2.1% for adults). The significantly increase in prevalence occurred across most sociodemographic strata, in which those strata of having higher prevalence also had greater increase in absolute difference. Regarding use of other substance, the increase in absolute difference was much greater for adolescents than for adults, e.g., an increase of 26.2% for cigarette users, 24.7% for areca nut users, whereas the figures were 7.4% and 6.1% for adults. People with mediate-to-high depression had greater increase in e-cigarette use, 1.7% for adolescents and 4.8% for adults, as compared to those with low score in depression, 1.7% for adolescents and 2.1% for adults. Among past year e-cigarette users, 20% of had nicotine dependence of medium to high magnitude. Conclusion: The prevalence of e-cigarette use had significantly increase from 2014 to 2018. Among them, the male gender, being aged 15 to 17 years or young adults, and some sociodemographic features were associated with greater changes in the prevalence. Among both adolescents and adults, greater changes in the prevalence were associated with cigarette smoking, alcohol drinking, areca nut chewing, two levels of nicotine dependence, and two levels of problematic alcohol use. About one fifth of past year e-cigarettes users exhibited a medium to high degree of nicotine dependence.