Tobacco use among U.S. adolescents is on the rise due to the advent of electroni

Question

Tobacco use among U.S. adolescents is on the rise due to the advent of electronic cigarettes, according to recent studies (CDC, 2015). For this discussion, create a cohort study to test the hypothesis that teenagers are more likely to try electronic cigarettes the first time they use tobacco, and answer the following questions: What is the exposure being studied by this hypothesis? How might you measure the exposure in your cohort study? How might you identify cases in this study? What additional factors would you measure in this study? What are some of the limitations you might encounter when measuring first time electronic cigarette use? Since adolescent and teenage use might be a rare event to capture, would you consider utilizing a case-control study? How would you design a case-control study to test the hypothesis?

Explanation / Answer

1. The exposure being studied in the hypothesis is teenagers using tobacco for the first time.

2. Data on the exposures of interest may be obtained through personal interviews (either face-to-face or by telephone), self-administered questionnaires, diaries of behaviour, reference to records, biological measurements and measurements in the environment. If a subject is too young, too ill, or dead, it is also common to obtain data from a proxy respondent, usually a member of their family. The method chosen to collect data depends on many factors: the type of study; the type and detail of data required; availability of existing records collected for other purposes; lack of knowledge or poor recall of the exposure by subjects; sensitivity of the subjects to questioning about the exposure; frequency and level of the exposure, and their variability over time; availability of physical or chemical methods for measuring the exposure in the human body or in the environment; and the costs of the various possible methods. Often, more than one approach is used. Different components of the data often require different collection methods, and using several methods of data collection can help to validate data and to reduce error in measurement.

Cohort study designs have several advantages over case-control studies in terms of exposure measurement. If exposure measurement occurs before disease occurrence, cohort studies are much less prone to differential measurement error. Prospective data collection should also reduce measurement error due to poor recall of past exposures. The primary drawback of cohort studies is the large sample size leading to high data collection costs. The approaches to reduce such costs can be selection of lower cost measurement methods and fully measuring the exposure only on a subsample of the cohort

3. The cases for cohort study need to be chosen very wisely. We should understand the cases general behaviour and choices and then make a judicious choice to include in the study

4. The information obtained should include details of the exact nature of the exposure, its amount or dose, and its distribution over time.

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