Integrated Health, Behavioral and Economic Research on Current and Emerging Tobacco Products

项目摘要/摘要 经过几十年的稳定，人们使用的烟草产品及其使用方式正在发生变化。香烟 使用量继续下降，但电子烟、雪茄和湿鼻烟的使用量正在增加，并使用多种产品 正变得越来越普遍。新的“热不灼伤”产品正作为改良风险被提交给FDA 烟草产品。只有一个有限的证据基础来告知监管和公共沟通 对这些变化的反应。这项TCORS的综合主题是了解结合健康 效果、行为和影响分析将为监管和公众提供可操作的信息 关于当前和新兴烟草产品的交流。这种融合体现在以下事实上： 几个项目属于多个域。TCORS的具体目标是：(1)评估短期 对健康的影响，包括对呼吸和心血管的影响，电子烟、热而不灼伤等 烟草产品以及特定烟草产品特性如何影响健康效果和行为；(2) 建立科学基础，为这些烟草产品的产品标准和营销法规提供信息， 将烟草使用的健康和行为层面与经济模型结合起来，特别是 强调特定的产品特性和以前研究不足的短期影响；以及(3) 为博士后研究员、初级教员和符合以下条件的资深教员实施职业提升计划 目前没有参与监管科学研究的烟草监管科学建设研究 通过辅导、发展赠款和其他支持，建立社区。我们将实现这些目标 通过5个项目：(1)不同电子烟特性对急性肺损伤的影响；(2)短期 电子烟的心血管效应：设备功率和电子烟液体pH值的影响，以及电子烟如何 与热不灼伤产品比较；(3)新兴热不灼伤烟草对心血管健康的影响 产品；(4)农村地区现有和新兴的烟草产品：产品的影响 感知、行为和生物暴露的特征；以及(5)改变烟草的影响 产品使用对普通人群和弱势人群的医疗成本。四核将支持这些 项目：(1)行政管理；(2)职业发展；(3)统计和信息学；(4)生物标记全部 项目和核心相互作用，相互支持，增加集体影响。对健康的影响 (项目1、2、3)和行为(项目4)项目相互通知，并通过 将改进监管影响分析的经济模型(项目5)。量化对健康的影响 烟草产品的具体设计方面对于确定监管机会很重要。在……里面 特别是，因为FDA的监管影响分析中大幅贴现了遥远未来的福利， 确定短期健康影响对于准确的监管影响评估非常重要。

PROJECT SUMMARY/ABSTRACT After decades of stability, the tobacco products people use and the way they use them are changing. Cigarette use continues to decline, but e-cigarette, cigar, and moist snuff use are increasing and use of multiple products is becoming more common. New “heat-not-burn” products are being proposed to the FDA as modified risk tobacco products. There is only a limited evidence base to inform regulatory and public communication responses to these changes. The integrative theme of this TCORS is that understanding combined health effects, behavior, and impact analysis will provide actionable information for regulation of and public communications about current and emerging tobacco products. This integration is reflected by the fact that several projects fall within more than one domain. The TCORS' specific aims are: (1) Evaluate the short-term health effects, including respiratory and cardiovascular effects, of e-cigarettes, heat-not-burn, and other tobacco products and how specific tobacco product characteristics influence health effects and behavior; (2) Develop the science base to inform product standards and marketing regulations for these tobacco products, integrating the health and behavioral dimensions of tobacco use with economic models, with particular emphasis on specific product characteristics and previously under-studied short-term effects; and (3) Implement a career enhancement program for postdoctoral fellows, junior faculty, and established faculty who are not currently involved in regulatory science research to build the tobacco regulatory science research community through mentoring, developmental grants, and other support. We will accomplish these aims through 5 projects: (1) Impact of Different E-cigarette Characteristics on Acute Lung Injury; (2) Short-term Cardiovascular Effects of E-cigarettes: Influence of Device Power and E-liquid pH, and How E-cigarettes Compare with Heat-not-burn Products; (3) Cardiovascular Health Effects of Emerging Heat-Not-Burn Tobacco Products; (4) Current and Emerging Tobacco Products in a Rural Context: Influences of Product Characteristics on Perceptions, Behaviors, and Biologic Exposures; and (5) Impact of Changing Tobacco Product Use on Healthcare Costs for General and Vulnerable Populations. Four cores will support these projects: (1) Administration; (2) Career Enhancement; (3) Statistics and Informatics; and (4) Biomarker All projects and cores interact to support each other and increase their collective impact. The health effects (Projects 1, 2, and 3) and behavior (Project 4) projects inform each other and are further integrated through economic models (Project 5) that will improve regulatory impact analyses. Quantifying the health effects of specific design aspects of tobacco products is important for identifying opportunities for regulation. In particular, because benefits far in the future are heavily discounted in the FDA's regulatory impact analysis, identifying short-term health effects is important for accurate regulatory impact assessment.