Vaping among Smokers, a Cherokee Nation Cohort Study

吸烟是美洲印第安人 (AI) 面临的一个紧迫的公共卫生问题，也是造成不平等的一个主要原因 在癌症死亡率方面。越来越多的成年人吸烟也使用电子烟（e-cigs），或者作为一种消遣。 帮助戒烟或减少吸烟。关于电子烟的使用或“vaping”的报道很少， 尽管这些产品在全国范围内的使用迅速增长，但人工智能仍然受到人们的关注。我们项目的具体目标是： 1. 描述切罗基成年 AI 吸烟者电子烟使用的基线流行率和模式 国家，包括使用电子烟的原因，例如戒烟的愿望、电子烟使用的持续时间和强度， 首选尼古丁浓度、口味和蒸汽装置特性。假设：吸电子烟的人会更多 比其他吸烟人群中报道的更为常见。 2. 评估与电子烟和吸烟双重使用相关的基线特征。假设：电子烟 用户将更年轻，女性居多，更渴望戒烟，并且每次吸烟的数量更少 一天比非用户。电子烟的流行率不会因尼古丁依赖程度而有所不同。 3. 检查电子烟双重使用者之间烟草成分的基线生物标志物是否存在差异 和香烟使用者与只吸烟者相比。探索性的子目标是评估可行性 收集尿液以测量参与者子样本的 NNAL。假设：构成程度 暴露程度与电子烟对香烟的替代程度直接相关。更大的替代将 导致接触有毒物质一氧化碳的水平较低，而尼古丁标记物没有差异。 4. 18 个月后重新评估电子烟和吸烟情况。假设：电子烟的使用普及率将 随着时间的推移而增加。使用电子烟将在 18 个月时预测以下结果： 吸烟量减少 每天吸烟，尼古丁依赖减少，有害成分含量降低，但不能戒烟。 该拟议研究项目探索电子烟和可燃香烟的双重使用 美洲印第安人 (AI) 在与 P20 切诺基相关的三个总体目标的背景下 国家/史蒂芬森癌症中心癌症差异研究合作：1) 解决当前的差距 我们对人工智能吸烟者使用电子烟的了解； 2）提高研究能力和专业知识 两名人工智能新兴研究人员，一名在切罗基国家，一名在史蒂芬森癌症中心；和 3) 在切罗基族和史蒂芬森癌症之间建立持久的合作研究关系 NCI 未来中心资助研究人工智能中与烟草相关的癌症。这项工作具有创新性 因为它将实时捕捉电子烟对吸烟和有毒物质暴露标记不断变化的影响 和高危人群中的尼古丁成瘾。这项工作是翻译性的，正如许多美国社区一样， 无论种族构成如何，都面临着高吸烟率和电子烟使用量增加的问题。

Smoking is a pressing public health problem for American Indians (AI) and is a major contributor to disparities in cancer mortality. Increasingly, adults who smoke are also using electronic cigarettes (e-cigs), either as an aid for smoking cessation or to reduce smoking. Very little has been reported about e-cig use, or “vaping”, among AI despite the burgeoning use of these products nationwide. The Specific Aims of our project are to: 1. Describe baseline prevalence and patterns of e-cig use among adult AI smokers in the Cherokee Nation, including reasons for e-cig use such as desire to quit smoking, duration and intensity of e-cig use, preferred nicotine concentration, flavors, and vapor device characteristics. Hypothesis: Vaping will be more common than reported in other smoking populations. 2. Assess baseline characteristics associated with dual use of e-cigs and smoking. Hypotheses: E-cig users will be younger, more often female, more desirous of quitting smoking, and use fewer cigarettes per day than non-users. Prevalence of vaping will not differ by level of nicotine dependence. 3. Examine whether baseline biomarkers of tobacco constituents differ between dual users of e-cigs and cigarettes compared to cigarette-only users. An exploratory sub-aim is to assess the feasibility of urine collection to measure NNAL on a subsample of participants. Hypotheses: The degree of constituent exposure will be directly associated with degree of e-cig substitution for cigarettes. Greater substitution will confer lower levels of exposure to the toxicant carbon monoxide, with no difference in markers of nicotine. 4. Reassess vaping and smoking after 18 months. Hypotheses: The prevalence of use of e-cigs will increase over time. Use of e-cigs will predict the following outcomes at 18 months: fewer cigarettes smoked per day, less nicotine dependence, lower levels of harmful constituents, but not smoking cessation. This proposed research project explores dual use of electronic cigarettes and combustible cigarettes among American Indians (AI) in the context of three overarching goals related to the P20 Cherokee Nation/Stephenson Cancer Center Collaborative on Cancer Disparities Research: 1) to address current gaps in our understanding of the use of e-cigs among AI smokers; 2) to increase the research skills and expertise of two AI emerging investigators, one at the Cherokee Nation and one at the Stephenson Cancer Center; and 3) to build an enduring collaborative research relationship between the Cherokee Nation and Stephenson Cancer Center for future NCI sponsored studies addressing tobacco-related cancer among AI. This work is innovative because it will capture in real time the evolving impact of e-cigs on smoking and markers of toxicant exposure and nicotine addiction in a high risk population. This work is translational, as many U.S. communities, regardless of racial composition, face high rates of smoking and rising use of e-cigs.