Longitudinal Study of Adolescent Tobacco Use and Tobacco Control Policy in India

印度青少年烟草使用和烟草控制政策的纵向研究

• 批准号: 9175358
• 负责人: Ritesh I Mistry
• 金额: $ 60.22万
• 依托单位: UNIVERSITY OF MICHIGAN AT ANN ARBOR
• 依托单位国家: 美国
• 财政年份: 2016
• 资助国家: 美国
• 起止时间: 2016-08-25 至 2021-12-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9175358
• 关键词: 13 year old; Adolescent; Adult; Advertisements; Advertising; Behavioral; Cardiovascular Diseases; Cessation of life; Child Rearing; Chronic Obstructive Airway Disease; Cigarette; Cities; Cohort Studies; Communities; Data; Data Collection; Development; Disease; Electronic cigarette; Environment; Environmental Risk Factor; Environmental Tobacco Smoke; Exposure to; Family; Future; Geographic Information Systems; Goals; Government; Head; Health; Household; India; Individual; Institutes; Institution; Knowledge; Label; Laws; Lead; Longitudinal Studies; Los Angeles; Maps; Marketing; Measures; Mediating; Michigan; Minor; Parents; Policies; Policy Developments; Population; Population Growth; Premature Mortality; Public Health; Public Health Schools; Research; Research Design; Research Personnel; Risk; Risk Behaviors; Risk Factors; Sales; Sampling; Smoke; Smokeless Tobacco; Socioeconomic Status; Staging; Surveys; Tobacco; Tobacco Industry; Tobacco smoke; Tobacco use; Tobacco-Related Carcinoma; Universities; Variant; Vendor; Youth; abstracting; burden of illness; cancer risk; cohort; density; effective intervention; environmental tobacco smoke exposure; experience; follow-up; improved; low and middle-income countries; member; population based; public health priorities; public policy on tobacco; response; socioeconomics; symposium; tobacco advertising; tobacco control; tobacco prevention; trend

Project Summary/Abstract This project will use a multilevel longitudinal cohort study design to assess whether changes in Community Tobacco Environmental (CTE) factors, measured as community compliance with tobacco control policies and community density of tobacco vendors and advertisement, are associated with adolescent tobacco use initiation in urban India. The project will also assess how family level factors moderate and individual level factors mediate the associations between CTE factors and adolescent tobacco use. Annually, an estimated 1 million deaths in India are attributable to tobacco use making it a leading cause of premature mortality. India became an early adopter of the WHO Framework Convention for Tobacco Control. A key set of India's tobacco control policies pertain to Articles 8, 13 and 16 of the FCTC regarding secondhand smoke exposure, access to tobacco products and tobacco promotion. India's policies include smoke-free laws; restrictions on tobacco advertisements; bans on the sale of tobacco products to minors and within 100 yards of educational institutions, recent bans on the sale of gutkha (a particularly dangerous smokeless tobacco product), and new requirements for highly prominent warning labels on tobacco packaging. In addition, the recent emergence of e-cigarettes in the Indian tobacco marketplace will require new policy responses. Research data about community level compliance with tobacco control policies, access to and promotion of emerging products like e-cigarettes, and their association with youth tobacco use, are largely unavailable, and are needed to inform policy development. Therefore, we aim to: (1) Administer a comprehensive longitudinal population-based tobacco use risk factors survey on a cohort of 2,040 12-13 year old adolescents (and their parent) for four waves form baseline (Wave 1) to 36 months follow-up (Wave 4). (2) Concurrently, measure Community Tobacco Environmental factors in the 68 communities from where the adolescent sample will be drawn. We will use Geographic Information Systems data collection to map and audit tobacco vendors, COTPA defined public places, tobacco advertisements, availability of e-cigarettes, and compliance with tobacco control and smoke-free laws. (3) Estimate the longitudinal associations between CTE factors and adolescent tobacco use, and assess whether the associations are moderated by family level factors (e.g., parent tobacco use, household tobacco use policy, parenting factors, and household socioeconomic status), and meditated by individual level factors (e.g., perceived ease of access to tobacco including access to gutkha and e-cigarettes, perceived tobacco use norms, perceived tobacco use harms, exposure to tobacco ads, and exposure to secondhand smoke).The geographic scope will include Mumbai and Kolkata, India, cities that span from the West to the East coast of India, and represent large variations in adolescent tobacco use, socioeconomic development, cultural factors and Community Tobacco Environmental factors.

项目总结/摘要 本项目将采用多水平纵向队列研究设计，以评估社区 烟草环境因素（CTE），衡量为社区对烟草控制政策的遵守情况， 社区烟草销售商密度和广告与青少年烟草使用相关 在印度城市的开始。该项目还将评估家庭层面的因素如何适度和个人层面的因素如何适度。 因素介导CTE因素和青少年烟草使用之间的关联。每年估计有1 在印度，有1000万人死于烟草使用，使其成为过早死亡的主要原因。印度 成为世界卫生组织烟草控制框架公约的早期采用者。印度烟草的关键一套 与《烟草控制框架公约》第8、13和16条有关的控制政策， 烟草产品和烟草促销。印度的政策包括无烟法;对烟草的限制 广告;禁止向未成年人和100码内的教育机构销售烟草产品 机构，最近对gutkha（一种特别危险的无烟烟草产品）的销售的禁令，以及新的 要求在烟草包装上高度突出的警告标签。此外，最近出现的 印度烟草市场的电子烟将需要新的政策回应。研究数据关于 社区一级遵守烟草控制政策，获得和推广新兴产品， 电子烟及其与青少年烟草使用的关联，在很大程度上是不可用的，需要告知 政策制定。因此，我们的目标是：（1）管理一个全面的纵向人口为基础的 对2，040名12-13岁青少年（及其父母）进行了为期四年的烟草使用风险因素调查 从基线（第1波）到36个月随访（第4波）。(2)同时，测量社区 烟草68个社区的环境因素，青少年样本将从那里抽取。我们 COTPA规定，将使用地理信息系统数据收集来绘制和审计烟草供应商 公共场所、烟草广告、电子烟的可获得性以及遵守烟草控制和 无烟法律(3)估计CTE因素与青少年烟草使用之间的纵向关联， 并评估这些关联是否受到家庭水平因素的调节（例如，父母烟草使用， 家庭烟草使用政策、养育因素和家庭社会经济地位），并由 个体水平因子（例如，感觉容易获得烟草，包括获得gutkha和电子烟， 感知烟草使用规范、感知烟草使用危害、烟草广告暴露以及 地理范围将包括印度的孟买和加尔各答，这两个城市横跨 印度西海岸到东海岸，青少年烟草使用、社会经济 发展、文化因素和社区烟草环境因素。