Effectiveness of Tobacco Control Policies in High vs. Low Income Countries

描述（由申请人提供）：本项目（P01）探讨不同的烟草控制政策（如产品标签、无烟政策、价格和税收以及产品监管）在不同收入和文化的不同国家的有效性是否相对一致或不一致。拟议的研究建立在国际烟草控制政策评估联盟（简称ITC项目）开始的工作的基础上，该项目得到了我们跨学科烟草使用研究中心的部分资助（TTURC - P50 CA111236）。ITC项目的目的是采用严格的评估方法，试图了解作为《烟草控制框架公约》一部分实施的烟草控制政策的影响。ITC项目的优势在于其独特的设计，利用了多个国家的比较，每年跟踪吸烟者的纵向队列，以及预先指定的、理论驱动的中介模型，以检验有关特定烟草控制政策预期效果的假设。本申请中的三个项目均包含评估药剂、宿主和环境因素对烟草使用行为影响的措施和方法，方法和重点略有不同。项目1考察了在18个高、低收入和中等收入国家的不同群体中，在人口层面衡量的不同烟草控制政策的相对一致性。项目2在烟草包装和标签领域扩展了项目1的工作，重点是为中低收入国家的新政策建立证据。项目3探讨了高收入国家和中低收入国家之间的烟草产品差异，政策如何影响产品特征，以及尼古丁代谢等先天宿主特征如何与产品特征相互作用，从而影响烟草使用行为。总体而言，本P01的调查结果将有助于确定不同的烟草控制政策如何发挥作用，国家之间和国家内部效果的一般性，并最终使政府了解有必要调整政策干预措施，以便在《烟草控制框架公约》政策实施的下一个关键五年期间实现最大效果。

DESCRIPTION (provided by applicant): This program project (P01) explores the question of whether different tobacco control policies (e.g., product labeling, smoke-free policies, price and taxation, and product regulation) are relatively consistent or inconsistent in effectiveness across different countries with varying incomes and cultures. The proposed research builds upon the work started by the International Tobacco Control Policy Evaluation consortium (referred to as the ITC Project), which has been supported in part by our Transdisciplinary Tobacco Use Research Center grant (TTURC - P50 CA111236). The ITC Project was established with the aim of applying rigorous evaluation methods to try to understand the impact of the tobacco control policies implemented as part of the Framework Convention on Tobacco Control (FCTC). The strength of the ITC Project has been its unique design utilizing multiple country comparisons, longitudinal cohorts of smokers tracked annually, and a pre-specified, theory-driven mediational model to test hypotheses about the anticipated effects of a given tobacco control policy. Each of the three projects in this application incorporate measures and methods to assess the impact of agent, host, and environmental factors on tobacco use behaviors with slight variations in approach and emphasis. Project 1 examines the relative consistency of different tobacco control policies measured at the population level across a diverse group of 18 high and low and middle-income countries (LMICs). Project 2 extends the work of Project 1 within the area of tobacco packaging and labeling with a focus upon building the evidence for novel policies in LMICs. Project 3 explores how tobacco products differ between high and LMICs, how policies impact product features, and how innate host characteristics such as nicotine metabolism interact with product features to influence tobacco use behaviors. Collectively, the findings from this P01 will help define how different tobacco control policies work, the generality of effects between and within countries, and ultimately inform governments about the need to tailor policy interventions to achieve maximum effectiveness during the next critical five year period of FCTC policy implementation.