Impact of e-cigarette characteristics and marketing on tobacco use and health: A longitudinal study among U.S. youth and adults

电子烟特征和营销对烟草使用和健康的影响：针对美国青少年和成年人的纵向研究

• 批准号: 10217787
• 负责人: Nan Jiang
• 金额: $ 24.46万
• 依托单位: NEW YORK UNIVERSITY SCHOOL OF MEDICINE
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-06-01 至 2023-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10217787
• 关键词: Address; Adult; Advertising; Affect; Attention; Behavior; Cardiovascular system; Characteristics; Cigarette; Cigarette Smoker; Data; Decision Making; Devices; Elderly; Electronic cigarette; Epidemic; Exposure to; Frequencies; Future; Generations; Goals; Health; High School Student; Incidence; Internet; Intervention; JUUL; Knowledge; Lead; Logistic Regressions; Longitudinal Studies; Marketing; Mediating; Mediation; Menthol; Nicotine; Nicotine Dependence; Oral health; Outcome; Perception; Periodontal Diseases; Population Assessment of Tobacco and Health; Predisposition; Pulmonary Heart Disease; Regression Analysis; Regulation; Reporting; Risk; Role; Sampling; Smoker; Smoking; Smoking Behavior; Symptoms; System; Testing; Tobacco; Tobacco use; Weight; Withdrawal Symptom; Youth; addiction; cardiovascular health; cardiovascular risk factor; cigarette advertising; cigarette smoking; combat; design; electronic cigarette use; electronic cigarette user; former smoker; junior high school; never smoker; non-smoker; respiratory; respiratory health; secondary outcome; smoking relapse; social media; tobacco control; tobacco flavor; tobacco user; young adult

PROJECT SUMMARY/ABSTRACT E-cigarette use has increased rapidly, particularly among youth and young adults. The appealing flavors are a primary reason for young people to initiate and continue to use e-cigarettes. Young adult nonsmokers are more likely to initiate e-cigarette use with non-tobacco and non-menthol (NTM) flavors rather than tobacco and menthol (TM) flavors compared to current smokers, which is worrisome because e-cigarette use leads to cigarette initiation. The types of e-cigarette may also contribute to the surge in e-cigarette use. Advanced generation (open-system) devices deliver nicotine faster than old generation (closed-system) devices and can rapidly reduce withdrawal symptoms. Understanding if and how e-cigarette flavors and device types affect tobacco use behaviors is fundamental to developing regulatory activities that address the epidemic of e- cigarette use. In addition, e-cigarettes have been marketed aggressively using strategies that are appealing to young people. Youth exposure to e-cigarette advertising leads to e-cigarette initiation and greater susceptibility. But the underlying mechanism has not been fully explored. A potential mechanism is that advertising exposure reduces perceived harms and addictiveness of e-cigarettes, which in turn, lead to e- cigarette initiation and susceptibility. Last, e-cigarette use is associated with elevated risks for cardiopulmonary and periodontal diseases. However, evidence has been predominantly from cross-sectional data or on relatively small samples. To fill the knowledge gap, we will use longitudinal data (Waves 1-4) from the Population Assessment of Tobacco and Health (PATH) Study to accomplish three specific aims: (1) identify the impact of e-cigarette flavors and types on e-cigarette use among youth (12-17 years), young adults (18-34 years), and older adults (35 years and older). We will perform multivariate logistic regression with propensity score weights to assess the overall impact of e-cigarette flavors (NTM vs. TM) and types (open vs. closed- system) on e-cigarette use frequency. We will perform causal mediation analysis to test the hypothesis that, compared to TM flavors, NTM flavored e-cigarette use reduces harm and addiction perceptions of e-cigarettes, which lead to more frequent e-cigarette use; (2) determine the impact of exposure to e-cigarette advertising on e-cigarette initiation, use frequency, and susceptibility. Similar to Aim 1, we will perform multivariate logistic regression to assess the effect of e-cigarette advertising exposure on the outcomes, and conduct causal mediation analyses to assess the mediating effect of harm and addiction perceptions of e-cigarettes; and (3) identify the effect of e-cigarette use on cardiovascular, respiratory, and periodontal health, and compare the effects among different types of tobacco users (e.g., exclusive e-cigarette users never cigarette smokers, exclusive e-cigarette users former cigarette smokers, dual users, and cigarette-only smokers). Findings from our study will be directly relevant to regulatory decision-making that address e-cigarette flavors, product design and marketing practices, and will inform future interventions that tackle the epidemic of e-cigarette use.

项目总结/摘要 电子烟的使用迅速增加，特别是在青年和年轻人中。吸引人的口味是 年轻人开始并继续使用电子烟的主要原因。不吸烟的年轻人 可能会开始使用非烟草和非薄荷醇（NTM）口味的电子烟，而不是烟草， 薄荷醇（TM）口味相比，目前的吸烟者，这是令人担忧的，因为电子烟的使用导致 香烟引发。电子烟的类型也可能导致电子烟使用的激增。先进 新一代（开放系统）装置比老一代（封闭系统）装置更快地输送尼古丁， 迅速减少戒断症状。了解电子烟口味和设备类型是否以及如何影响 烟草使用行为是制定应对电子烟流行的监管活动的基础， 香烟使用此外，电子烟一直在积极营销，使用吸引人的策略， 年轻人青少年接触电子烟广告导致电子烟开始和更大 易感性但其内在机制尚未得到充分探讨。一个潜在的机制是， 广告曝光减少了电子烟的感知危害和成瘾性，这反过来又导致电子烟 香烟引发和易感性。最后，电子烟的使用与心肺疾病的风险增加有关。 和牙周病。然而，证据主要来自横截面数据或 相对较小的样本。为了填补知识空白，我们将使用纵向数据（波1-4）， 烟草与健康的人口评估研究，以实现三个具体目标：（1）确定 电子烟口味和类型对年轻人（12-17岁）、年轻人（18-34岁）使用电子烟的影响 老年人（35岁及以上）。我们将进行多变量logistic回归， 评分权重，以评估电子烟口味（NTM vs. TM）和类型（开放式vs.封闭式- 电子烟使用频率。我们将进行因果中介分析来检验假设， 与TM口味相比，使用NTM口味的电子烟减少了对电子烟的伤害和成瘾感， 导致更频繁使用电子烟;（2）确定暴露于电子烟广告对 电子烟的开始，使用频率和易感性。与目标1类似，我们将执行多变量logistic 回归，以评估电子烟广告曝光对结果的影响，并进行因果关系 中介分析，以评估电子烟危害和成瘾感知的中介作用;以及（3） 确定使用电子烟对心血管，呼吸和牙周健康的影响，并比较 不同类型的烟草使用者之间的影响（例如，独家电子烟使用者从不吸烟， 独家电子烟使用者前香烟吸烟者，双重使用者和只吸烟者）。的结果 我们的研究将直接关系到解决电子烟口味，产品设计， 和营销实践，并将为未来应对电子烟使用流行的干预措施提供信息。