Personal factors, product characteristics, and changes in biomarkers of exposure among cigarette smokers who switch to noncombustible tobacco products.

在美国，香烟是发病率和死亡率的主要可预防原因，尽管戒烟是 减少吸烟相关危害的最佳方法，大多数吸烟者无法戒烟。吸烟者不能 戒烟但希望减少吸烟的潜在危害可考虑改用不可燃烟草 无烟烟草或电子烟等产品。然而，意外的后果，如 双重用途可能会减轻这些不可燃产品的潜力，以减少与吸烟有关的危害。这个 长期目标是减轻吸烟造成的健康和经济负担。总体目标 在这一应用中是为了表征吸烟者中的产品过渡，以评估影响因素 与转变为不可燃物相关，并评估不可燃物的潜在危害 减量策略。过渡模型概述了吸烟者可能遵循的四种轨迹--续 吸烟(最不理想的结果)，完全戒烟(最理想的结果)，独占的非梳子使用 (可能减少危害)或双重/多聚烟草使用(不太可能减少危害)。这些轨迹将是 通过使用烟草与健康人口评估研究的二次数据分析进行评估- 关于烟草使用行为和健康的纵向的、具有全国代表性的数据集。该项目通过以下方式填补了空白 定义谁将转向不可燃产品，哪些产品和功能可能会导致他们 成功转换，以及转换后他们的健康和接触生物标记物的情况如何变化 产品。目标1是确定与从香烟转向 不可燃物--关注社会人口学特征、吸烟史、危害认知和 暴露在消息中。目标2是描述与转换相关的产品特性 从香烟到不可燃物品--同时关注卷烟特性和不可燃特性 (例如，味道、尼古丁含量)，以便于切换。目标3是检查健康结果和暴露情况 已改用不可燃产品的吸烟者的生物标志物--以确定这些转变是否会导致 对健康有意义的改善。该项目响应FDA烟草产品研究中心 与行为和健康影响有关的优先事项，例如产品特性对烟草使用的影响 行为与人类健康。该项目具有创新性，因为它包括对 使用具有全国代表性的大型数据集改用不可燃物的相关因素。这 项目是有影响力的，因为它将评估不可燃物作为一种减少危害的战略的效用。 该项目的成功完成将产生关于潜在干预目标和产品的数据 通过减少巨大的社会健康和经济成本而使公共健康受益的监管 与吸烟有关。

Cigarettes are the leading preventable cause of morbidity and mortality in the US, and though quitting is the optimal method to reduce smoking-related harms, most smokers are unable to quit. Smokers who are unable to quit but wish to reduce potential harms of smoking may consider switching to noncombustible tobacco products such as smokeless tobacco or electronic cigarettes. However, unintended consequences such as dual use may mitigate the potential of these noncombustible products to reduce smoking -related harms. The long-term goal is to reduce the health and economic burden caused by cigarette smoking. The overall objective in this application is to characterize product transitions among cigarette smokers to evaluate the factors associated with transitioning to noncombustibles and assess the potential of noncombustibles as a harm reduction strategy. The transition model outlines four trajectories that a smoker may follow – continued smoking (least optimal outcome), complete cessation (most optimal outcome), exclusive noncomb ustible use (possible harm reduction) or dual/poly tobacco use (unlikely to be harm reduction). These trajectories will be evaluated through a secondary data analysis using the Population Assessment of Tobacco and Health Study – a longitudinal, nationally representative dataset on tobacco use behaviors and health. This project fills a gap by defining who is switching to noncombustible products, which products and features may lead them to successfully switch, and how their health and exposure to biomarkers changes as a result of switching products. Aim 1 is to identify personal characteristics associated with switching from cigarettes to noncombustibles – focusing on sociodemographic characteristics, smoking history, harm perceptions, and exposure to messaging. Aim 2 is to characterize product characteristics associated with switching from cigarettes to noncombustibles – focusing both on cigarette characteristics and noncombustible characteristics (e.g., flavor, nicotine content) that facilitate switching. Aim 3 is to examine health outcomes and exposure biomarkers in smokers that have switched to noncombustible products – to determine if these transitions result in meaningful improvements to health. This project is responsive to FDA Center for Tobacco Products research priorities relating to behavior and health effects, such as the impact of product characteristics on tobacco use behaviors and human health. This project is innovative because it includes comprehensive assessment of factors associated with switching to noncombustibles using a large, nationally representative dataset. This project is impactful because it will evaluate the utility of noncombustibles as a harm reduction strategy. Successful completion of this project will generate data on potential targets for intervention and product regulation that can benefit public health by reducing the immense societal health and economic costs associated with cigarette smoking.