Toxicant Exposure and Harm Perceptions in Cigarette Smokers Who Use or Do Not Use E-Cigarettes

项目摘要/摘要 这项建议解决了关于一个重大公共卫生问题--电子产品的使用--的研究中的一个关键空白 吸烟者的香烟(ECs)。吸烟者将减少吸烟带来的危害作为吸烟的主要原因 使用ECs，而ECs已被烟草研究人员建议作为潜在的减少危害的载体 不能或不会实现戒烟的吸烟者。然而，目前对黄曲霉毒素的毒理学知识 ECS主要局限于实验室测试，在行为研究中几乎没有相应的证据。作为第一个 人类行为EC研究中，毒物通过烟草特有的亚硝胺NNAL暴露，高度 将测量潜在的肺癌致癌物，该项目将解决该领域的一个关键障碍，并 促进广泛使用EC用于减少危害的实践的科学进步。此外，这将是第一次 研究确定ECs的摄取如何影响持续烟草使用中涉及的认知-感知因素， 例如风险认知、吸烟的效用、戒烟的自我效能和烟草依赖。这项研究直接 与美国国立卫生研究院解决癌症风险因素的使命相关，并支持降低 烟草使用的疾病负担。在目前的提案中，不打算戒烟的吸烟者 吸烟，表示对减少危害感兴趣，以及从未经常使用EC(一生中25次)将会 以2：1的方式随机分为EC组(n=120)或仅评估对照组(n=60)。那些 随机选择EC将获得12周供应的第二代EC初学者试剂盒，并提供他们选择的液体 标准单子上的味道。那些仅随机接受评估的患者(n=60)将不提供EC。烟草 两组的摄入量将在0周(基线)、4周、8周和12周进行评估。 (NNAL，一种主要的肺癌致癌物和主要结果)和一氧化碳(CO)将被测量 从基线到第12周。目标1将表征随机到 EC组与吸烟者进行随机比较，仅进行评估对照；Aim 2将评估 电子烟的使用对人们对产品的危害和效用的认知的影响；目标3将说明 改用电子烟的吸烟者的烟草产品消费(可替宁验证)和身份 这些模式的基线预测因素，包括人口统计、吸烟史和心理社会 特点。该项目将推动广泛使用EC用于减少危害的实践的科学进展 是已知的第一项通过NNAL接触毒物和认知-感知变量变化的研究 将描述改用EC的吸烟者的特征，并与继续使用EC的吸烟者进行比较 光是香烟。研究结果将对公众健康产生重大影响，特别是对患有 在戒烟方面遇到困难，对谁使用EC作为减少伤害的策略 考虑过了。这项研究将改善PI大学的研究环境，该大学被归类为 西班牙裔服务机构和亚裔美国原住民-太平洋岛民服务机构。

Project Summary/Abstract This proposal addresses a critical gap in the research regarding a major public health issue – use of electronic cigarettes (ECs) by smokers. Smokers cite reducing perceived harm from smoking as a leading reason for using ECs, and ECs have been suggested by tobacco researchers as a potential harm reduction vehicle for smokers who cannot or will not achieve smoking cessation. However, current knowledge of the toxicology of ECs is primarily limited to lab tests, with very little corresponding evidence in behavioral studies. As the first human behavioral EC study in which toxicant exposure via the tobacco-specific nitrosamine, NNAL, a highly potent pulmonary carcinogen will be measured, this project will address a critical barrier in the field and advance science on the widely used practice of EC use for harm reduction. Furthermore, this will be the first study to determine how uptake of ECs affects cognitive-perceptual factors involved in sustained tobacco use, such as risk perceptions, utility of smoking, self-efficacy to quit, and tobacco dependence. This study is directly relevant to the NIH’s mission to address cancer risk factors and supports the long-term objective to reduce the disease burden of tobacco use. In the current proposal, cigarette smokers who are not planning to quit smoking, express interest in harm reduction, and who have never been regular EC users (< 25 times in life) will be randomized in a 2:1 fashion to an EC group (n=120) or an assessment-only control group (n=60). Those randomized to EC will receive a 12 week supply of a second generation EC starter kit with their choice of liquid flavor from a standard list. Those randomized to assessment only (n=60) will not be provided with EC. Tobacco consumption in both groups will be assessed at weeks 0 (baseline), 4, 8, and 12. Changes in toxic exposure (NNAL, a primary lung carcinogen and the primary outcome) and carbon monoxide (CO) will be measured from baseline to week 12. Aim 1 will characterize the toxic exposure of cigarette smokers randomized to the EC group compared to cigarette smokers randomized to assessment-only controls; Aim 2 will assess the effects of uptake of e-cigarettes on perceptions of harm and utility of products; Aim 3 will illuminate patterns of tobacco product consumption (cotinine-verified) among smokers switching to electronic cigarettes and identify baseline predictors of those patterns, including demographic, smoking history, and psychosocial characteristics. This project will advance science on the widely used practice of EC use for harm reduction by being the first known study in which toxicant exposure via NNAL and change in cognitive-perceptual variables among smokers switching to EC will be characterized and compared to smokers who continue to use cigarettes alone. Study findings will have major public health implications, particularly for smokers who have experienced difficulty in quitting cigarettes and for whom EC use as a harm reduction strategy has been considered. The study will enhance the research environment at the PI’s university which is classified as both a Hispanic Serving Institution and an Asian American-Native American-Pacific Islander Serving Institution.