Electronic cigarettes in Latin America: Evaluation of impacts and policy options

项目摘要 电子香烟，也被称为电子尼古丁输送系统（ENDS），正在迅速蔓延 世界各地，包括低收入和中等收入国家（LMIC）。这项研究将有助于了解 ENDS的影响和监管政策。我们将与国际烟草控制组织合作 政策评估项目，该项目最近获得了一大笔赠款，用于评估使用ENDS的影响及其 高收入国家的法规（即，加拿大，英国，美国）与对比的政策。拟议 该项目将在墨西哥和危地马拉收集原始数据，以便将其纳入这一努力。的 该项目的具体目标如下： AIM 1.比较危地马拉青少年使用ENDS的开始和后果， 墨西哥，两个烟草政策环境截然不同的邻国。我们将调查和 跟踪2000名危地马拉青少年，了解是什么促进了ENDS的使用，以及它是否导致他们 开始使用传统香烟。一项试验将评估ENDS政策的备选方案（例如，警告， 营销禁令）。结果将与我们目前正在收集数据的墨西哥青年进行比较。 AIM 2.在已确定的成年吸烟者中确定ENDS使用的预测因素和结果， 墨西哥我们将调查参与我们先前研究的成年吸烟者，以及招募的吸烟者。 在线，以了解ENDS的使用是否通过帮助他们戒烟或减少 他们抽的烟。结果将与其他国家进行比较。 AIM 3.描述危地马拉和墨西哥ENDS产品的标签、设计和成分。 我们将分析ENDS设备和“电子液体”（即，设备蒸发的液体），以评估： 1.标记（例如，警告，营销）; 2.设备设计（例如，电池强度）; 3.电子液体成分（例如， 尼古丁、调味剂、毒物）。我们将评估时间趋势和跨国差异。 AIM 4.采用模拟模型预测ENDS和香烟使用趋势，包括公众 不同ENDS政策对健康的影响。我们将建立在我们之前在墨西哥的模拟研究，使用 目标1-3的数据和正在进行的研究，以将ENDS的使用纳入模拟模型。该模型将 预测尼古丁产品使用的未来趋势以及不同政策对公共卫生的影响。 通过实现这些目标，我们将加强危地马拉和墨西哥的能力， 对ENDS的观察，实验和模拟研究，以告知最佳的发展 结束政策的实践。该项目将建立在研究小组成员的长期和 在整个拉丁美洲的烟草研究能力建设中发挥根本作用， 可以制定政策，以应对ENDS和该区域烟草控制的其他新挑战。 1

PROJECT SUMMARY Electronic cigarettes, also known as electronic nicotine delivery systems (ENDS), are rapidly spreading around the world, including to low- and middle-income countries (LMICs). This study will help understand the impacts of ENDS and the policies to regulate them. We will collaborate with the International Tobacco Control Policy Evaluation Project, which recently received a large grant to evaluate the impact of ENDS use and its regulations across high-income countries (i.e., Canada, England, US) with contrasting policies. The proposed project would collect original data in Mexico and Guatemala in order to integrate them into this effort. The project has the following specific aims: AIM 1. Compare the initiation and consequences of ENDS use among adolescents in Guatemala and Mexico, two neighboring countries with contrasting tobacco policy environments. We will survey and follow 2000 Guatemalan adolescents to understand what promotes ENDS use and whether it leads them to start using conventional cigarettes. An experiment will assess options for ENDS policy (e.g., warnings, marketing bans). Results will be compared to Mexican youth, from whom we are currently collecting data. AIM 2. Determine the predictors and outcomes for ENDS use among established adult smokers in Mexico. We will survey adult smokers who participated in our prior research, as well as smokers recruited online, in order to understand whether ENDS use reduces harm by helping them quit or reduce the number of cigarettes they smoke. Results will be compared with other countries. AIM 3. Characterize the labeling, design and constituents of ENDS products in Guatemala and Mexico. We will analyze ENDS devices and “e-liquids” (i.e., liquids that devices vaporize) in both countries, to assess: 1. labeling (e.g., warnings, marketing); 2. device design (e.g., battery strength); 3. e-liquid constituents (e.g., nicotine, flavorings, toxicants). We will assess time trends and cross-country differences. AIM 4. Adapt a simulation model for predicting trends in ENDS and cigarette use, including the public health impact of different ENDS policies. We will build on our prior simulation research in Mexico, using data from Aims 1-3 and ongoing studies to integrate ENDS use into the simulation model. The model will project future trends in nicotine product use and the public health impacts of different policies. By achieving these aims, we will strengthen capacity in Guatemala and Mexico for conducting observational, experimental, and simulation research on ENDS, in order to inform the development of best practices for ENDS policies. The project will build upon research team members' longstanding and fundamental role in tobacco research capacity building across Latin America, so that sound public health policies can be developed to address ENDS and other emerging challenges to tobacco control in the region. 1