青少年電子煙使用與吸菸意圖或吸菸行為之關聯性：系統性文獻回顧

Association of e-cigarette use with smoking intentions and behaviors among adolescents: a systematic review

世界衛生組織指出，吸菸為全球主要的健康危險因子。近年來電子煙在青少年族群中的使用率逐漸提升，而青少年電子煙使用與其未來吸菸意圖及行為的關聯仍有爭論。本文以PubMed、PsycINFO、CINAHL資料庫、與華藝線上圖書館，系統性回顧2014年1月至2018年2月，以中、英文發表的青少年電子煙使用與其未來吸菸意圖及行為相關研究，共納入18篇符合納入規範的文獻。現有研究多來自於美國，且多為橫斷性設計，僅有少數追蹤不超過一年的縱貫性研究。我們依循部分理性行動論的架構，將研究結果歸納成「電子煙使用與吸菸意圖之關聯」與「電子煙使用與吸菸行為之關聯」兩大主軸。結果指出，青少年的電子煙使用與其吸菸意圖、吸菸行為及吸菸的數量與頻率均呈正相關。建議未來研究採用長期的縱貫性設計，以利於確認其因果關聯，作為公共衛生研究與實務之參考。 The World Health Organization reported that smoking is a primary health risk factor. The prevalence of e-cigarette use in adolescents has increased recently. However, the association of e-cigarette use with smoking intentions and behaviors is unconfirmed. Through PubMed, PsycINFO, CINAHL, and Airiti Library, this study systematically reviewed studies published in English or Chinese language that have examined the association of adolescent's e-cigarette use with smoking intentions and behaviors from January 2014 to February 2018. We identified 18 empirical studies satisfying the respective criteria. Most of the studies had cross-sectional designs and were from the United States; only a few longitudinal studies had follow-up periods of less than 1 year. Based on the Theory of Reasoned Action, this systematic review provided some evidence of positive associations between e-cigarette use and smoking intentions, smoking behavior, and smoking frequency among adolescents. Future research must investigate the association of e-cigarette use with smoking-related behaviors by using longitudinal designs with long-term follow-ups to determine the respective causality for informing subsequent policymaking and research.