Modeling the public health impact of a flavored cigar ban

模拟调味雪茄禁令对公共健康的影响

• 批准号: 10665869
• 负责人: Sarah Mills
• 金额: $ 67.96万
• 依托单位: UNIV OF NORTH CAROLINA CHAPEL HILL
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-09-30 至 2028-08-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10665869
• 关键词: Address; Adult; Affect; Behavior; Black race; Characteristics; Cigar; Cigarette; Cigarette Smoker; Collaborations; Communication; Country; Data; Demographic Impact; Disease; Effectiveness; Electronic cigarette; Ethnic Origin; Face; Health; Health Benefit; Individual; Inequity; Legal; Literature; Low income; Maintenance; Marketing; Markov Chains; Menthol; Modeling; Monitor; North Carolina; Pattern; Persons; Pharyngeal structure; Phase; Policies; Population; Population Assessment of Tobacco and Health; Population Group; Positioning Attribute; Poverty; Prevalence; Probability; Public Health; Race; Reduce health disparities; Regulation; Research; Research Priority; Sales; Science; Smoke; Smoking; Study models; Subgroup; System; Taste Perception; Time; Tobacco; Tobacco use; United States; United States Food and Drug Administration; Universities; Update; Youth; cigarette smoke; cigarillos; combustible tobacco; contextual factors; design; ethnic minority; health disparity; improved; models and simulation; mortality; mortality disparity; polytobacco use; population health; racial minority; systematic review; tobacco control; tobacco flavor; tobacco products; tobacco regulation; tobacco regulatory science; tobacco user; tool

ABSTRACT: PROJECT 3 The objective of this project is to estimate the public health impact of a federal flavored cigar ban on tobacco use, mortality and health disparities in the United States. This project will build a microsimulation model of individuals living in the US who are current, former, or potential users of cigars, cigarettes and e-cigarettes. The model can be used to track tobacco use over time, so the impact of a flavored cigar ban on smoking and mortality in the US population and in priority populations for tobacco control, such as among people who are Black or have lower incomes, can be estimated. The microsimulation model will be built in three phases corresponding to the specific aims. Specifically, using data from the nationally representative, longitudinal Population Assessment of Tobacco and Health study, we will estimate tobacco use transition probabilities over time, with a focus on the effects of cigar use on initiation, cessation, and dual/poly use of tobacco products (Aim 1). We will conduct a systematic review to compile data on cigar users’ tobacco use after a flavored cigar ban and elicit potential policy design effects from tobacco experts. Tobacco experts will be asked to develop plausible and distinct flavored cigar ban scenarios to simulate and compare, and quantify how key post-ban contextual factors (e.g., policy enforcement) affect the impact of the ban (Aim 2). Finally, using findings from Aims 1 and 2, and estimates from the literature, we will build a microsimulation model to estimate how tobacco use and mortality changes in the presence of a federal flavored cigar ban and in plausible moderating circumstances, such as with weak tobacco retailer compliance with a ban (Aim 3). This project will provide a comprehensive understanding of the potential public health impact of a flavored cigar ban, critical scientific evidence to counter likely legal challenges against a federal ban. We will also identify key threats to policy effectiveness for the Food and Drug Administration (FDA) to monitor and address in collaboration with local and state partners to maximize the public health benefits of the policy. This project addresses FDA research priorities to assess the impact of tobacco product characteristics (i.e., flavors) on initiation and cessation (Behavior, Aim 1) and to understand the public health impact of potential FDA regulatory action on tobacco use behavior and health (Impact Analysis, Aims 2 and 3). The University of North Carolina (UNC) Tobacco Centers of Regulatory Science (TCORS) has deep expertise in tobacco regulation and communications. The Center’s Integrative Theme is building the science for effective regulation of and communication about tobacco products disproportionately used by priority populations – flavored tobacco products.

摘要：项目3 本项目的目的是评估联邦风味雪茄禁令对烟草的公共卫生影响 使用，死亡率和健康差距在美国。本项目将建立一个微观仿真模型， 居住在美国的个人，他们是雪茄，香烟和电子烟的当前，以前或潜在用户。 该模型可用于跟踪烟草使用随着时间的推移，因此，口味雪茄禁令对吸烟的影响， 美国人口和烟草控制优先人群的死亡率，例如 黑人或有较低的收入，可以估计。微观模拟模型将分三个阶段建立 符合具体目标。具体而言，使用具有全国代表性的纵向数据， 烟草与健康研究的人口评估，我们将估计烟草使用的过渡概率 时间，重点是雪茄使用对烟草产品的开始，停止和双重/多重使用的影响 (Aim 1）。我们将进行一项系统性的审查，以收集雪茄使用者在食用调味雪茄后的烟草使用数据。 禁止烟草，并从烟草专家那里获得潜在的政策设计影响。烟草专家将被要求制定 合理的和不同的口味雪茄禁令的情况下，模拟和比较，并量化如何关键后禁令 背景因素（例如，政策执行）影响禁令的影响（目标2）。最后，利用来自 目的1和2，并估计从文献中，我们将建立一个微观模拟模型，以估计如何烟草 在联邦风味雪茄禁令的存在下， 在某些情况下，例如烟草零售商对禁令的遵守情况不佳（目标3）。该项目将提供一个 全面了解调味雪茄禁令的潜在公共卫生影响，关键科学 证据来对抗可能对联邦禁令提出的法律的挑战。我们还将确定对政策的主要威胁 美国食品和药物管理局（FDA）与当地合作监测和解决问题的有效性 和国家合作伙伴，以最大限度地扩大该政策的公共卫生效益。该项目涉及FDA研究 评估烟草产品特性影响的优先事项（即，口味）的起始和终止 （行为，目标1）并了解FDA对烟草使用的潜在监管行动对公共卫生的影响 行为和健康（影响分析，目标2和3）。北卡罗来纳州大学（北卡罗来纳州）烟草中心 TCORS在烟草监管和沟通方面拥有深厚的专业知识。该中心的 综合主题是建立科学的有效监管和烟草产品的沟通 不成比例地被重点人群使用--调味烟草产品。