Local Flavor Policies to Enhance Equity in Tobacco

摘要 美国各地正在制定限制调味烟草产品（FTP）销售的政策。 我们试图扩大这些政策在多大程度上减少获得金融交易平台的证据基础， 这可能会减少青少年和年轻人的烟草使用。 此外，很少有研究探讨这些政策在减少烟草相关健康差距方面的潜力 在有色人种和社会经济地位较低的青年/年轻人群体中。这些弱势 人群以更高的比率使用调味产品，并且在这些人群的社区中大量销售FTPs。 弱势群体生存。确定FTP政策的总体影响以及对有色人种和社会经济地位较低人群的影响 这些社区的青年/年轻成年人可以确保政策的结构能够确保公平覆盖 减少烟草使用的差异。本研究的目的是确定风味政策对 减少脆弱青年/年轻成年人接触和使用家庭治疗方案。使用策略实现 框架和埃克塞特-利克雷模型作为我们的理论指导，我们将联合收割机国家、地方和 个人数据，以研究美国各地风味政策的股票影响。为了达到研究目的 我们将实现几个目标。(1)我们将使用青年和年轻人的纵向国家数据集（n= 13，892） 从2014年开始，每年两次进行九波跟踪，以检查烟草营销暴露和FTP的变化 以及暴露于FTP策略但随着时间的推移没有暴露FTP策略的人中的非FTP使用，重点是 种族/民族和SES的差异。(2)我们将比较FTP/非FTP的营销曝光率和吸引力 通过生态瞬时性，在由风味政策变体覆盖的社区中， 评估（EMA），根据个体的SES和人种/种族评价结局差异， 邻里水平。(3)最后，在EMA参与者中，我们将评估暴露于 6个月随访时FTP和非FTP使用的FTP/非FTP营销暴露，并评估 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 考虑到FTP策略。实现本R 01的目标将扩大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使用的潜在公平影响， 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.