Vaping among Smokers, a Cherokee Nation Cohort Study

吸烟是美国印第安人面临的一个紧迫的公共卫生问题，也是造成差异的主要因素。 在癌症死亡率上。越来越多的吸烟成年人也在使用电子烟（e-cigs）， 帮助戒烟或减少吸烟。关于电子烟的使用，或“vaping”， 尽管这些产品在全国范围内的使用迅速增长，但人工智能仍在发展。我们项目的具体目标是： 1.描述切罗基地区成年AI吸烟者使用电子烟的基线患病率和模式 国家，包括电子烟使用的原因，如戒烟的愿望，电子烟使用的持续时间和强度， 优选的尼古丁浓度、风味和蒸汽装置特性。假设：Vaping将更多 比其他吸烟人群中报告的更为常见。 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 吸烟者将更年轻，更常为女性，更渴望戒烟， 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.检查烟草成分的基线生物标志物是否在电子烟的双重用户之间存在差异 和香烟相比，一个探索性的次级目标是评估 收集尿液以测量参与者子样本的NNAL。假设：构成程度 接触电子烟与电子烟取代香烟的程度有直接关系。更大的替代将 给予较低水平的暴露于有毒的一氧化碳，尼古丁的标记没有差异。 4. 18个月后重新评估vaping和吸烟。假设：使用电子烟的普及率将 随时间增加。使用电子烟将在18个月时预测以下结果：吸烟减少 减少尼古丁依赖，降低有害成分的水平，但不是戒烟。 这项拟议的研究项目探讨了电子香烟和可燃香烟的双重用途， 美国印第安人（AI）在与P20切罗基相关的三个总体目标的背景下 国家/斯蒂芬森癌症中心合作癌症差异研究：1）解决目前的差距， 我们对人工智能吸烟者使用电子烟的理解; 2）提高研究技能和专业知识， 两名人工智能新兴研究人员，一名在切罗基国家，一名在斯蒂芬森癌症中心; 3） 在切罗基民族和斯蒂芬森癌症之间建立持久的合作研究关系 未来NCI中心赞助的研究解决了AI中与烟草相关的癌症。这项工作是创新的 因为它将在真实的时间内捕捉电子烟对吸烟和有毒物质暴露标志物的不断变化的影响 和尼古丁成瘾的风险。这项工作是翻译，因为许多美国社区， 无论种族构成如何，都面临着吸烟率高和电子烟使用率上升的问题。

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.