Local Flavor Policies to Enhance Equity in Tobacco

摘要 美国各地正在制定限制销售调味烟草产品(Ftp)的政策。 我们寻求扩大证据基础，说明这些政策在多大程度上减少了获得FTP和 这可能会减少青少年和年轻人对烟草的使用。 此外，很少有研究考察这些政策在减少与烟草有关的健康差距方面的潜力。 在有色人种和社会经济地位较低(SES)的青年/青年成年人口中。这些易受攻击的 人们使用调味产品的比率更高，FTP在这些社区大量销售 弱势群体活着。确定FTP策略的总体影响以及对有色人种和较低SES人群的影响 这些社区的年轻人/年轻人可以确保政策的结构，以确保公平的覆盖 并减少烟草使用差异。这项研究的目的是确定风味政策对 减少弱势青年/青壮年接触和使用FTP。使用策略实施 框架和精化可能性模型作为我们的理论指导，我们结合了国家、地方和 考察美国各地风味政策对公平的影响的个人数据。为了达到研究目的 我们将实现几个目标。(1)我们将使用全国青年和青壮年纵向数据集(n=13,892) 从2014年开始，每年跟踪9次浪潮，检查烟草营销曝光率和ftp的变化 以及在那些暴露于FTP策略而不会随着时间的推移不暴露FTP策略的人中使用非FTP，重点放在 不同种族/民族和社会经济地位的差异。(2)我们将比较FTP/非FTP的营销风险敞口和吸引力 通过生态瞬间在风味政策变体覆盖的社区中的新兴成年人之间 评估(EMA)，根据SES和种族/民族在个人和 居民区水平。(3)最后，在EMA参与者中，我们将评估暴露于 在6个月的跟踪调查中，了解使用FTP和非FTP的ftp/非ftp营销风险，并评估是否 这些结果与社会经济地位和种族/民族有关。对于所有这些活动，我们将与 国家和地方的FTP政策专家，他们将向已经或正在 正在考虑一个FTP策略。实现本R01的目标将扩大关于ftp影响的证据基础 减少烟草使用的政策以及这些政策对减少烟草的潜在公平影响，并最终 癌症差异。

ABSTRACT Policies restricting the sale of flavored tobacco products (FTP) are being enacted in localities around the US. We seek to expand the evidence base about the extent to which these policies decrease access to FTPs and exposure to flavored tobacco marketing and would likely reduce use of tobacco among youth and young adults. Additionally, few studies examine the potential of these policies to reduce tobacco-related health disparities among youth/young adult populations of color and those of lower socioeconomic status (SES). These vulnerable populations use flavored products at higher rates and FTPs are heavily marketed in communities where these vulnerable groups live. Determining the impact of FTP policies overall and on populations of color and lower SES youth/young adults in these communities can make sure that policies are structured to ensure equitable reach and reduce tobacco use disparities. The purpose of this study is to determine the impact of flavor policies on reducing exposure to and use of FTPs among vulnerable youth/young adults. Using the Policy Implementation Framework and the Elaboration Likelihood Model as our theoretical guides, we combine national, local and individual data to examine the equity impact of flavor policies around the US. To accomplish the study purpose we will conduct several aims. (1) We will use a longitudinal national dataset of youth and young adults (n=13,892) followed for nine waves twice a year from 2014 to examine changes in tobacco marketing exposure and FTP and non-FTP use in those exposed to an FTP policy with no FTP policy exposure over time, focusing on differences by race/ethnicity and SES. (2) We will compare marketing exposure to and appeal of FTP/non-FTPs between emerging adults in communities covered by flavor policy variants through ecological momentary assessment (EMA), evaluating differences in outcomes by SES and race/ethnicity at the individual and neighborhood level. (3) Finally, among EMA participants, we will assess the predictive validity of exposure to FTP/non-FTP marketing exposure on use of FTP and non-FTPs at 6-month follow-up, and evaluate whether these outcomes are associated with SES and race/ethnicity. For all of these activities, we will partner with national and local FTP policy experts who will disseminate lessons learned to communities who have or are considering an FTP policy. Achieving the aims of this R01 will expand the evidence base of the impacts of FTP policies on reducing tobacco use and potential equity impact of these policies to reduce tobacco, and ultimately cancer disparities.