Vaping among Smokers, a Cherokee Nation Cohort Study

吸烟对美国印第安人来说是一个紧迫的公共健康问题，也是造成差异的主要原因 癌症死亡率。吸烟的成年人也越来越多地使用电子烟，要么作为一种 帮助戒烟或减少吸烟。关于电子烟的使用，或“电子烟”的报道很少， 在人工智能中，尽管这些产品在全国范围内的使用蓬勃发展。我们项目的具体目标是： 1.描述切罗基成年人工智能吸烟者使用电子烟的基线流行率和模式 国家，包括使用电子烟的原因，如戒烟的愿望，使用电子烟的时间和强度， 首选尼古丁浓度、味道和蒸气装置特性。假设：Vaping将会更多 在其他吸烟人群中比报道的更常见。 2.评估与双重使用电子烟和吸烟有关的基线特征。假设：e-cig 吸烟者将更年轻，更多的是女性，更渴望戒烟，并且每人使用更少的香烟 天数比非用户的多。吸烟的流行程度不会因尼古丁依赖程度的不同而不同。 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有所不同 与只吸烟的人相比，吸烟的人更多。一个探索性的子目标是评估 收集尿液以测量参与者子样本上的NNAL。假设：构成的程度 接触电子烟将直接与电子烟取代香烟的程度有关。更大的替代性将 接触有毒一氧化碳的水平较低，尼古丁的标志物没有差异。 4.18个月后重新评估吸电子烟和吸烟。假设：电子烟的普遍使用将 随着时间的推移而增加。使用电子烟可以预测18个月后的以下结果：吸烟量减少 每天减少对尼古丁的依赖，降低有害成分的水平，但不会戒烟。 这项拟议的研究项目探讨了电子烟和可燃香烟的双重用途 美国印第安人(AI)在与P20切诺基相关的三个首要目标的背景下 国家/斯蒂芬森癌症中心关于癌症差异的合作研究：1)解决目前在 我们对人工智能吸烟者使用电子烟的了解；2)增加研究技能和专业知识 2名人工智能新兴调查人员，1名在切诺基国家，1名在斯蒂芬森癌症中心；3) 在切诺基民族和斯蒂芬森癌症之间建立持久的合作研究关系 NCI未来中心赞助了关于人工智能中与烟草相关的癌症的研究。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志的不断变化的影响 以及尼古丁成瘾的高危人群。这项工作是翻译的，就像许多美国社区一样， 无论种族构成如何，他们都面临着高吸烟率和越来越多的电子烟使用。

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.