Understanding Transitions from Vaping to Smoking Across Adolescence

项目摘要/摘要 尽管青少年电子烟的使用激增(即，电子烟)，而且有证据表明电子烟与 开始吸烟，研究蒸发是否会增加进展为常规依赖的风险 关于吸烟模式和这些风险途径背后的因素的研究很少。因此，有有限的 用于指导干预措施的数据，以保护日益增长的青少年尿布人口不会过渡到 抽烟。我们假设，支持烟草的社会环境(例如，较低的社会经济环境 吸烟可能更被接受，靠近烟草零售商，有吸烟的朋友)可能会放大 从吸电子烟过渡到经常吸烟和依赖的风险，特别是在患有积极吸烟和依赖的年轻人中 对他们最初的蒸发体验的感觉-药物反应，因此他们可能更倾向于 用其他烟草产品进行试验。该项目将利用来自两个持续的纵向队列的数据 研究电子烟对14-20岁青少年吸烟进展和依赖风险的预测作用 (汇集N~3700；目标1a)以及社会环境和早期蒸发经验作为调节因素的作用 这一风险途径(目标1b)；我们还将检查这些关联是否因性别和年龄而不同(目标1c)。 在一个平行的项目中，我们将对这些队列中的年轻人进行定性访谈，以揭示新的因素 影响这一过渡的因素(N=60；目标2)。AIMS 1和AIMS 2的结果将用于生成新的 一项评估“从吸电子烟到吸烟的易感性”这一新概念的心理调查我们会 对两个队列(N=200；目标3)的青年尿布的子集进行初步验证研究。调查结果将 在以下方面提供信息：(1)阐明蒸发可能对人群健康造成的危害 青少年吸烟，这对指导制定政策和监管青少年吸烟行为非常重要；以及 指导制定预防战略，以应对社会环境和改变蒸发现象 在迅速增长的使用电子烟的青少年人口中减少吸烟风险的经验。 作为一名流行病学家和不断增长的烟草经验，我带着很强的量化技能进入这个项目 研究。这个K01对我在支持我的长期目标的领域发展专业知识至关重要 成为一名独立的、多学科交叉的环境和个人研究人员 青少年吸烟和其他药物使用的决定因素。所建议的培训将有助于我的发展 A)青少年成瘾发展心理病理学方面的专长，b)定性研究方法， 以及c)调查项目的调查设计和心理测量测试，并在指导下进一步完善我的技能 在应用我的研究为政策和预防工作提供信息方面。我与我的导师们密切合作 (根据他们在每个培训领域的专长进行选择)制定一项雄心勃勃但可行的培训计划， 包括专家指导、定向阅读、课程作业和研讨会、科学会议以及继续 手稿和赠款写作技能的发展。

PROJECT SUMMARY / ABSTRACT Despite the proliferation of adolescent e-cigarette use (i.e., vaping) and evidence of associations of vaping with cigarette initiation, research on whether vaping increases the risk of progression to regular, dependent smoking patterns and on factors that underlie these risk pathways are scant. Consequently, there are limited data to guide interventions to protect the growing population of adolescent vapers from transitioning to smoking. We hypothesize that a pro-tobacco social environment (e.g., lower socioeconomic environment in which smoking may be more accepted, proximity to tobacco retailers, having friends who smoke) may amplify the risk of transition from vaping to regular smoking and dependence, particularly among youth with a positive sensory-pharmacological response to their initial vaping experience who may therefore be more inclined to experiment with other tobacco products. This project will leverage data from two ongoing longitudinal cohorts to study vaping as a predictor of risk of smoking progression and dependence in adolescents aged 14-20 (Pooled N~3700; Aim 1a) and the role of the social environment and early vaping experience as moderators of this risk pathway (Aim 1b); we will also examine whether these associations differ by gender and age (Aim 1c). In a parallel project, we will conduct qualitative interviews with youth in these cohorts to uncover novel factors that influence this transition (N=60; Aim 2). Results from Aims 1 and 2 will be used to generate a new psychological survey to assess a novel construct of `susceptibility to transition from vaping to smoking.' We will conduct an initial validation study in a subset of youth vapers from both cohorts (N=200; Aim 3). Findings will be informative in (1) elucidating the possible harms that vaping may pose to population health by increasing youth smoking, which is important to guide development of policies and regulation of youth vaping; and (2) guiding the development of prevention strategies to address the social environment and alter the vaping experience to mitigate the risk of smoking among the rapidly increasing population of vaping adolescents. I enter this project with strong quantitative skills as an epidemiologist and growing experience in tobacco research. This K01 is critical for me to develop expertise in areas that will support my long-term goals to become an independent multi-disciplinary investigator of the intersecting environmental and intrapersonal determinants of adolescent tobacco and other drug use. The training proposed will help me to develop expertise in a) adolescent developmental psychopathology of addiction, b) qualitative research methodologies, and c) survey design and psychometric testing of survey items, with mentorship to additionally refine my skills in application of my research to inform policy and prevention efforts. I have worked closely with my mentors (selected based on their expertise in each training area) to develop an ambitious but feasible training plan that incorporates expert mentoring, directed readings, coursework and seminars, scientific meetings, and continued development of manuscript and grant writing skills.