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

在美国，吸烟是导致发病率和死亡率的主要可预防原因，尽管戒烟是预防吸烟的最佳方法。 最佳的方法来减少吸烟相关的危害，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，意想不到的后果，如 双重用途可能会降低这些不可燃产品减少吸烟相关危害的潜力。的 长期目标是减少吸烟造成的健康和经济负担。总体目标 在本申请中的目的是表征吸烟者之间的产品转换，以评估 与过渡到不可燃物相关，并评估不可燃物作为危害的可能性 减少战略。过渡模型概述了吸烟者可能遵循的四种轨迹-续 吸烟（最差结局）、完全戒烟（最佳结局）、完全非可梳性使用 （可能减少危害）或双重/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研究的人口评估进行的二级数据分析进行评估， 关于烟草使用行为和健康的纵向全国代表性数据集。该项目填补了一个空白， 定义谁正在转向不燃产品，哪些产品和功能可能导致他们转向 以及他们的健康和生物标志物暴露如何因转换而发生变化 产品.目的1是确定与从吸烟转向吸烟相关的个人特征。 不可燃物-侧重于社会人口学特征、吸烟史、危害认知和 暴露于信息。目标2是表征与从 卷烟转化为不可燃物-同时关注卷烟特性和不可燃特性 (e.g.,香料、尼古丁含量），以促进转换。目标3是检查健康结果和暴露 已改用不可燃产品的吸烟者中的生物标志物-以确定这些转变是否导致 对健康有意义的改善。该项目是响应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 行为和人类健康。这个项目是创新的，因为它包括全面评估 与使用大型全国代表性数据集转换为不可燃物相关的因素。这 该项目是有影响力的，因为它将评估不可燃物的效用作为减少危害的战略。 该项目的成功完成将产生关于干预和产品的潜在目标的数据。 通过减少巨大的社会健康和经济成本， 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.