Antecedents and Consequences of Electronic Nicotine Delivery Systems in Underrepresented Youth

项目摘要/摘要 尽管可燃卷烟消费率有所下降，但仍有约560万美国人 除非发病率继续下降，否则儿童预计会过早死于与吸烟有关的疾病。 考虑到电子尼古丁传递系统(END)是 2确定使用终端的前因和后果的前瞻性研究， 尤其是在代表不足的少数族裔群体中，是至关重要的。此外，澄清负面因素 终端使用对发育中的青少年大脑的健康影响是至关重要的。目标人群演示 包括西班牙裔/拉丁裔和黑人/非裔美国高中生在内的终端使用率最高的学生将 对减少烟草相关疾病的死亡率和发病率的影响最大。这个项目的目标是 是三重的。首先，我们将确定在高危人群中预测末梢发病的风险和保护因素 没有使用过任何物质的青少年，以及他们是否也预测了吸烟的发生。我们会 描述特定于目的的因素(例如，味道、对危害的感觉)以及相关的一般因素 物质使用启蒙，包括个性和社会背景。其次，考虑到对这一角色的好坏参半 作为一种潜在的入门药物，我们还将确定终端使用者是否更有可能转变为 与非吸毒者相比，吸烟、大麻和/或多种物质的使用。结束特定的因素，以及 与物质使用增加相关的因素，包括精神病理学和尼古丁依赖，将是 检查过了。第三，我们将描述开始使用END的青少年之间的神经生物学差异 那些没有使用核磁共振成像的人。我们将检查终端的使用情况，类似于 吸烟与前额叶腹内侧皮质和脑岛皮质厚度减少有关，并发生改变 奖赏加工过程中纹状体的功能活动。我们还将确定类似的大脑变化是否 在使用之前，在接触尼古丁之前对青少年进行扫描。这一点对于描述 神经生物学轨迹可能会让青少年走上上瘾的道路。我们将重点关注 在这一群体中，西班牙裔/拉丁裔和黑人/非裔美国高中生的终端使用率最高。 确定这一人群特有的风险和保护因素将有助于避免烟草使用差异。 此外，尽管大多数医疗保健提供者听说过END，但大多数人报告说知道的很少 关于这些产品，包括潜在的负面健康后果。关于发病的经验证据， 潜在的转变和最终使用对大脑的负面影响是帮助临床医生改进的关键 预防规划并协助政策制定者决定如何继续监管这些产品。通过 确定关键的可修改目标，这项工作将帮助医疗保健专业人员改进常规筛查， 物质使用咨询和预防性干预。

PROJECT SUMMARY/ABSTRACT Despite reductions in combustible cigarette consumption rates, approximately 5.6 million American children are expected to die prematurely from a smoking-related illness unless rates continue to decline.1 This statistic is particularly staggering when considering that electronic nicotine delivery systems (ENDS) are increasing in popularity.2 Prospective studies identifying antecedents and consequences of ENDS use, especially among underrepresented racial minority groups, are paramount. Furthermore, clarifying the negative health effects of ENDS use on the developing adolescent brain is critical. Targeting populations demonstrating the highest rates of ENDS use, including Hispanic/Latino and Black/African American high school students, will have the greatest impact on reducing mortality and morbidity from tobacco-related illness. This project's aims are three-fold. First, we will identify risk and protective factors that predict the onset of ENDS among high-risk adolescents without prior substance use, and whether or not they also predict cigarette onset. We will characterize factors specific to ENDS (e.g., flavoring, perceptions of harm), as well as general factors associated with substance use initiation including personality and social contexts. Second, given mixed findings on the role of ENDS as a potential gateway drug, we will also determine whether ENDS-users are more likely to transition to cigarettes, marijuana, and/or polysubstance use compared to non-users. ENDS specific factors, as well as factors associated with substance use escalation, including psychopathology and nicotine dependence, will be examined. Third, we will delineate neurobiological differences across adolescents having initiated ENDS use with those that have not using magnetic resonance imaging. We will examine whether ENDS use, similar to cigarette use, is linked with reduced cortical thickness in the ventromedial prefrontal cortex and insula and altered functional activity in the striatum during reward processing. We will also determine if similar brain alterations precede use by scanning adolescents prior to nicotine exposure. This is important to delineate the neurobiological trajectories that may place an adolescent onto a path for addiction. We will focus on Hispanic/Latino and Black/African American high school students as ENDS use is highest among this group.3,4 Identifying risk and protective factors specific to this population will help avert tobacco use disparities. Furthermore, although a majority of healthcare providers have heard of ENDS, most report knowing very little about these products including potential negative health consequences. Empirical evidence regarding the onset, potential transitions, and negative consequences on the brain of ENDS use is critical to help clinicians improve prevention programming and assist policy makers in deciding how to continue regulating these products. By identifying key modifiable targets, this work will help healthcare professionals improve routine screenings, substance use counseling, and preventive interventions.