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

早期开始吸烟和在关键的青少年和年轻成人时期快速发展预测 成年人长期吸烟和吸烟成瘾，健康后果风险高。但一直 关于青少年吸烟轨迹如何与未来对行业营销的脆弱性相关的研究很少， 旨在维持尼古丁成瘾的新兴产品。该项目解决了假设， 吸烟的早期过程是未来尼古丁依赖和易受影响的关键决定因素。 销售点和电子营销，导致未来使用新的非卷烟产品和聚乙烯烟草 使用.这些问题是使用超过12，000主要是西班牙裔和非西班牙裔白色的数据来解决的 1993年至1999年，从南加州学校招募的参与者进入儿童健康研究队列， 和2002吸烟数据每年收集一次，直到18岁的高中毕业。使用这些 数据和国家的最先进的统计建模，青少年吸烟轨迹的特点是 根据起始和进展模式。这些轨迹与邻域的关联， 社区环境、人口和社会因素，以及基于烟草的营销风险 零售商的接近度和密度在家里，学校和一个新的路线到学校的指标，将进行评估。样品 目前17 - 18岁的年轻招募浪潮中的吸烟者和高危非吸烟者（N = 600） 对26 - 36岁的早期吸烟者（N = 450）进行再次访谈和随访 前瞻性地评估生命早期吸烟轨迹与烟草产品感知的关系， 态度和信念，坚持使用和戒烟困难。烟草营销的具体类型 在销售点，通过电子和社交媒体，以及人际影响，放大了风险， 将查明儿童烟草使用的不同轨迹。分层建模方法将 关于生命早期吸烟轨迹、营销、看法、态度和信仰的综合信息 阶段和后续行动，以阐明每个阶段在使用新烟草产品中的作用。这项研究将产生 关于生命早期吸烟表型轨迹的性质和特征以及 应对与脆弱人群中的监管和预防有关的营销。此外，它将 阐明生命早期吸烟如何成为其他形式烟草产品使用的门户过程， 这可能会被烟草营销放大。它解决了FDA的研究重点：脆弱性， 认知、态度和信念，理解新产品的使用和营销。 相关性（参见说明）： 这项研究将根据早期吸烟情况，研究对新的和多种烟草产品的脆弱性 使用、营销和尼古丁依赖进入成年生活。FDA的监管研究重点包括 (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、态度和行为的影响 （B）了解有关烟草产品的沟通;以及（c） 了解通过社交及其他电子媒体和销售点营销新烟草产品;

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;