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

项目总结/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 使用继续下降，但电子烟，雪茄和湿鼻烟的使用正在增加， 变得越来越普遍。新的“热不燃烧”产品正在向FDA提出修改风险 烟草制品.只有有限的证据基础来告知监管和公众沟通 应对这些变化。本TCORS的综合主题是理解综合健康 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通信。这种融合反映在以下事实中： 若干项目属于一个以上的领域。TCORS的具体目标是：（1）评估短期 健康影响，包括呼吸和心血管影响，电子烟，热不燃烧，和其他 烟草产品以及特定烟草产品特性如何影响健康效应和行为;（2） 发展科学基础，为这些烟草产品的产品标准和营销条例提供信息， 将烟草使用的健康和行为维度与经济模型相结合，特别是 强调特定产品特性和先前未充分研究的短期影响;以及（3） 为博士后研究员，初级教师和已建立的教师实施职业提升计划， 目前没有参与烟草监管科学研究， 社区通过指导，发展赠款和其他支持。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：设备功率和电子液体pH值的影响，以及电子烟如何 与热不燃产品的比较;（3）新兴热不燃烟草对心血管健康的影响 （4）农村地区的现有和新兴烟草产品：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 一般人群和弱势人群的医疗保健费用产品使用。四个核心将支持这些 项目：（1）管理;（2）职业提升;（3）统计和信息学;和（4）生物标志物所有 项目和核心相互作用，相互支持，增加其集体影响。对健康的影响 （项目1、2和3）和行为（项目4）项目相互通报，并通过以下方式进一步整合： 经济模型（项目5），将改善监管影响分析。量化的健康影响 烟草制品的具体设计方面对于确定管制机会很重要。在 特别是，因为在FDA的监管影响分析中， 查明短期健康影响对于准确评估监管影响十分重要。

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.