健康与遗传心理学研究室知识库

近年来，我国电子烟使用人数逐年增加，电子烟的使用率已经上升到0. 9%,人数约为1035万。电子烟口味的多样化是使用人数增加的主要原因之一，同时电子烟中尼古丁含量的增加容易引发依赖行为。电子烟使用人数持续增加，引发的健康问题也日益凸显。于此背景，我国颁发并实施了电子烟相关管控政策。从2022年5月1日正式实施《电子烟管理办法》，规定“禁止销售除烟草口味外的调味电子烟和可自行添加雾化物的电子烟”，紧接着2022年10月1日正式执行《电子烟强制性国家标准(GB 41700-2022》，规定“雾化物应含有烟碱”和“雾化物中烟碱浓度不应高于20m1/g，烟碱总量不应高于200mg"。该管控政策执行后，成年人电子烟使用行为习惯的变化趋势和相关因素有待研究，以期为成年人电子烟使用提供有效建议、提高人群健康水平及为相关政策的执行和修订提供依据。

本研究通过腾讯问卷和问卷星线上发放编制的调查问卷，分别在2021年10月《电子烟管理办法》发布前、2022年5月《电子烟管理办法》刚发布、2023年2月《电子烟管理办法》开始执行一段时间后，针对三批不同被试进行调研，了解电子烟新政策发布前后的成年人电子烟使用行为习惯变化趋势，并探讨了成年人电子烟使用行为习惯变化及成年人是否吸电子烟的相关因素。数据采用SPSS27统计软件进行描述统计、卡方检验和二元Logistic回归分析。

主要研究结果:(1)目前电子烟使用行为习惯:成年人倾向于使用国产、非烟草口味、尼古丁含量为2%和3%的电子烟，过去30天使用电子烟的天数主要是1一2天，起床后第一支烟是传统香烟，一天中吸第一次电子烟的时间是早晨醒来后的16一3 0分钟，更喜欢在上午使用电子烟，每天使用电子烟量)1/4支; (2)电子烟新政策发布实施后:烟草口味电子烟使用人次占比增长。无尼古丁、2%尼古丁、4%尼古丁浓度电子烟使用占比增长，3%尼古丁和)5%尼古丁浓度电子烟使用占比减少;(3)电子烟新政策发布实施后，电子烟的使用量/频率变化在不同依赖程度成年人中具有显著差异。不依赖电子烟的成年人比其他依赖程度人群更倾向于减少吸电子烟;高依赖人群比其他人群更倾向于吸更多电子烟。(4)成年人使用电子烟的相关因素。研究:一方面将使用行为习惯变化作为因变量，发现尼古丁的浓度和口味管控政策改变了以往的使用行为习惯。另一方面，将是否会吸电子烟作为因变量，其相关因素分为个体因素和环境因素。个体因素中的人口学维度、吸传统香烟史、对电子烟认知态度情况均对成年人是否吸电子烟产生影响。吸过香烟正向预测成人吸电子烟。上瘾程度认知负向预测成年人吸电子烟。电子烟的戒烟效果正向预测成年人吸电子烟。环境因素上:使用电子烟的同伴的数量正向预测吸电子烟行为。对电子烟口味和尼古丁管控政策的了解影响吸电子烟行为。

结论:(1）电子烟管控政策出台前，成年人电子烟的使用行为习惯是倾向使用换弹式、非烟草口味、含量为3%尼古丁的电子烟;(2）电子烟新政策发布后，烟草口味的电子烟使用增加，高尼古丁浓度的电子烟使用减少，低尼古丁浓度的电子烟使用增加。不依赖电子烟的成年人比其他依赖程度人群更倾向于减少吸电子烟，高依赖人群比其他人群更倾向于吸更多电子烟。(3)个体因素和环境因素都对成年人是否吸电子烟产生影响，其中环境因素中的政策因素(即对尼古丁的浓度和口味管控政策)是人们是否吸电子烟的相关因素之一，知道两项政策中的任意一项(包括两项政策都知道)都正向预测吸电子烟行为。

In recent years, the number of e-cigarette users has increased year by year, and the rate of e-cigarette use has risen to 0.9%, which is about 10.35 million people. The variety of flavors in e-cigarettes is one of the main reasons for the increase in users, while the increased nicotine content in e-cigarettes is likely to trigger dependent behavior. As the number of people using e-cigarettes continues to rise, so do the health problems. In this context, China has issued and implemented e-cigarette related control policies. From May 1，2022, the Regulations on the Administration of e-cigarettes were officially implemented, stipulating that the sale of flavored e-cigarettes other than tobacco flavor and e-cigarettes that can add atomization by themselves are prohibited, followed by the official implementation of the Mandatory National Standard for e-Cigarettes (GB 41700一2022) on October 1，2022. "Aerosol should contain nicotine" and "aerosol nicotine concentration should not be higher than 20m1/g, total nicotine should not be higher than 200mg". After the implementation of this control policy, the change trend of adult e-cigarette use behavior and related factors need to be studied, in order to provide effective suggestions for adult e-cigarette use, improve the health level of the population and provide a basis for the implementation and revision of relevant policies.

In this study, three groups of different subjects were investigated before the release of e-cigarette Management Measures in October 2021，after the release of e-cigarette Management Measures in May 2022, and after the implementation of e-cigarette Management Measures in February 2023.To understand the changing trends of adult e-cigarette use behavior before and after the release of the new policy on e-cigarette, and to explore the changes of adult e-cigarette use behavior and the related factors of whether adults use e-cigarette. SPSS27 statistical software was used for descriptive statistics, Chi-square test and binary Logistic regression analysis.

Main findings: (1) Current e-cigarette use habits: Adults tend to use domestic, non-tobacco flavored e-cigarettes with 2% and 3% nicotine content. The number of days of use of e-cigarettes in the past 30 days is mainly 1 to 2 days, the first cigarette after waking up is a traditional cigarette, and the time to smoke their first e-cigarette is 16 to 30 minutes after waking up in the morning, preferring to use e-cigarettes in the morning. Use more than 1/4 e-cigarette per day; (2) After the release and implementation of the new policy on e-cigarettes: the proportion of users of tobacco-flavored e-cigarettes increased. Nicotine free, 2% nicotine, 4% nicotine concentration e-cigarette use increased, 3% nicotine and)5% nicotine concentration e-cigarette use decreased; (3) After the release and implementation of the new policy on e-cigarettes, the changes in the use/frequency of e-cigarettes have significant differences among adults with different degrees of dependence. Adults who did not rely on e-cigarettes were more likely to reduce their use than those with other levels of dependence; People with high dependency tend to use more e-cigarettes than other groups. (4) Factors associated with adult e-cigarette use. Research: On the one hand, the change of use behavior was taken as the dependent variable, and it was found that the nicotine concentration and taste control policy changed the previous use behavior. On the other hand, taking whether to smoke e-cigarettes as the dependent variable, the relevant factors are divided into individual factors and environmental factors. The demographic dimension of individual factors, the history of smoking traditional cigarettes, and the cognitive attitude towards e-cigarettes all influence whether adults use e-cigarettes. Cigarette smoking is positively predicting e-cigarette use in adults. Perception of addiction level negatively predicts adult e-cigarette use. Smoking cessation effectiveness of e-cigarettes is positively predictive of adult e-cigarette use. Environmental factors: The number of peers using e-cigarettes positively predicts vaping behavior. Knowledge of the taste of e-cigarettes and nicotine control policies influences vaping behavior.

Conclusions: (1) Before the introduction of the e-cigarette control policy, adults tend to use e-cigarettes with change-type, non-tobacco flavor and 3% nicotine content; (2) After the release of the new policy on e-cigarettes, the use of tobacco-flavored e-cigarettes increased, the use of high-nicotine e-cigarettes decreased, and the use of low-nicotine e-cigarettes increased. Adults who did not rely on e-cigarettes were more likely to reduce their use than those with other levels of dependence, and those with high levels of dependence were more likely to use e-cigarettes than those with other levels. (3) Both individual factors and environmental factors influence whether adults use e-cigarettes or governing nicotine not. Policy factors of environmental factors (that is, policies concentration and taste) are one of the relevant factors for whether people use e-cigarettes or not. Both policies (including both policies) are known to positively predict vaping behavior.