Project 3: Adolescent smoking: Vulnerability to Tobacco Use and Market p265-296

在青春期和青壮年关键时期早期开始吸烟和快速进展可预测 在成人生活中长期吸烟并上瘾，对健康的影响风险很高。然而，已经有了 很少有关于青少年吸烟轨迹与未来易受行业营销和 旨在维持尼古丁成瘾的新兴产品。这个项目解决了这样的假设： 早期吸烟是未来尼古丁依赖和易感性的关键决定因素 销售点和电子营销，导致未来使用新的非卷烟产品和烟草 使用。这些问题是使用12000多名主要是西班牙裔和非西班牙裔白人的数据来解决的 从南加州学校招募的参与者在1993年间加入了儿童健康研究队列 和2002年。吸烟数据是在18岁的高中毕业前每年收集的。 数据和最先进的统计模型，青少年吸烟的轨迹将被表征 基于启动和进展模式。这些轨迹与邻域和 社区环境、人口和社会因素，以及以烟草为基础的营销风险 将评估零售商在家中、学校和一条新的上学路线的接近度和密度。样本 吸烟者和高危非吸烟者在目前17-18岁的年轻招募浪潮中的比例(N=600) 26-36岁的早期吸烟者(N=450)将重新接受采访和跟踪 为了前瞻性地评估早期吸烟轨迹与烟草产品知觉的关系， 态度和信念、坚持使用和难以戒烟。烟草营销的具体类型 在销售点，通过电子和社交媒体，以及放大风险的人际影响 将确定儿童烟草使用的不同轨迹。分层建模方法将 整合有关早期生活中吸烟轨迹、市场营销、感知、态度和信仰的信息 各阶段和后续行动，以阐明每一阶段在使用新烟草产品中的作用。这项研究将产生 关于早期生活吸烟表型轨迹的性质和特征的精炼信息 对弱势群体中与监管和预防相关的营销作出反应。此外，它还将 阐明早年吸烟是如何成为使用其他形式烟草产品的门户过程， 这可能会被烟草营销放大。它阐述了FDA的研究重点：脆弱性、 认知、态度和信念，了解新产品的使用和营销。 相关性(请参阅说明)： 这项研究将根据早年的吸烟情况，检查人们对新的和多种烟草产品的易感性。 成人生活中的使用、营销和尼古丁依赖。FDA监管研究的优先事项包括 (A)烟草产品使用的多样性以及不同类型的营销对人们的看法和态度的影响 (B)了解有关烟草产品的沟通；及(C) 了解通过社交媒体和其他电子媒体以及在销售点销售新烟草产品的情况；

Early initiation of smoking and rapid progression during the key adolescent and young adult period predict chronic and addicted smoking in adult life and high risk for health consequences. However, there has been little research on how adolescent smoking trajectories relate to future vulnerability to industry marketing and emerging products intended to sustain nicotine addiction. This project addresses the hypothesis that the early course of cigarette smokino is a key determinant of future nicotine dependence and vulnerability to point-of-sale and electronic marketing, resulting in future use of new non-cigarette products and polv-tobacco use. These questions are addressed using data from over 12,000 largely Hispanic and non-Hispanic White participants recruited from Southern California schools into the Children's Health Study cohort between 1993 and 2002. Smoking data have been collected yearly through high school graduation at age 18. Using these data and state-of-the-art statistical modeling, adolescent cigarette smoking trajectories will be characterized based on initiation and progression patterns. Associations of these trajectories with neighborhood and community environmental, demographic and social factors, and with marketing exposure, based on tobacco retailer proximity and density at home, school and a novel route to school metric, will be assessed. Samples of smokers and at-risk non-smokers in the younger wave of recruitment currently 17-18 years of age (N=600) and of smokers from eariier waves now 26-36 years of age (N=450) will be re-interviewed and followed prospectively to assess the relationships of early life smoking trajectory with tobacco product perception, attitudes and beliefs, persistence of use and difficulty quitting smoking. Specific types of tobacco marketing at point-of-sale, through electronic and social media, and interpersonal influences that amplify the risk of different trajectories of childhood tobacco use will be identified. A hierarchical modeling approach will integrate information on early life smoking trajectory, marketing, perceptions, attitudes and beliefs across life stages and over follow-up to elucidate the role of each in use of new tobacco products. The study will yield refined information on nature and characteristics of early life smoking phenotype trajectories and on response to marketing relevant to regulation and prevention among vulnerable populations. Further, it will clarify how eariy-life cigarette smoking serves as a gateway process to other forms of tobacco product use, which could be amplified by tobacco marketing. It addresses FDA research priorities: vulnerability, perceptions, attitudes and beliefs, understanding new product use, and marketing. RELEVANCE (See instructions): The study will examine vulnerability, based on early life smoking profiles, to new and poly-tobacco product use, marketing and nicotine dependence into adult life. FDA regulatory research priorities addressed include (a) the diversity of tobacco product use and impact of different types of marketing on perceptions, attitudes and beliefs, and on products used; (b) understanding communication about tobacco products; and (c) understanding marketing of new tobacco products by social and other electronic media and at point-of-sale;