AppalTRuST Project 1: Population based Cohort study of tobacco use prevalence in Appalachian KY

AppalTRUST 项目 1：基于人口的肯塔基州阿巴拉契亚山脉烟草使用流行率队列研究

• 批准号: 10665320
• 负责人: Mary Kay Rayens
• 金额: $ 29.81万
• 依托单位: UNIVERSITY OF KENTUCKY
• 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/10665320
• 关键词: Address; Adult; Appalachian Region; Area; Attitude; Behavior; Catchment Area; Censuses; Characteristics; Cigar; Cigarette; Cities; Cohort Studies; County; Cues; Data; Disincentive; Disparity; Electronic cigarette; Enrollment; Equity; Funding; Future; Geographic Locations; Goals; Health; Heterogeneity; Income; Individual; Inequity; Interview; Kentucky; Knowledge; Longitudinal Studies; Longitudinal cohort; Longitudinal trends; Marketing; Masks; Measures; Menthol; Methods; Modeling; Nicotine; Participant; Pattern; Perception; Pharmaceutical Preparations; Policies; Positioning Attribute; Predisposition; Prevalence; Productivity; Publications; Reaction; Recording of previous events; Regulation; Research; Resources; Rest; Risk; Rural; Rural Appalachia; Rural Community; Rural Population; Shapes; Smokeless; Smokeless Tobacco; Surveys; Taxes; Testing; Time; Tobacco; Tobacco use; United States National Institutes of Health; Update; Urbanization; Variant; Visit; cigarette smoking; cigarillos; cohort; demographics; density; design; electronic cigarette use; health belief; health equity; heated tobacco products; hookah; informant; innovation; insight; low nicotine content cigarette; multidisciplinary; novel; peri-urban; policy implication; population based; recruit; residence; rural America; rural area; rurality; smoke-free policy; tobacco products; tobacco regulation; tobacco regulatory science; urban area

ABSTRACT – PROJECT 1 Rural populations, who use tobacco at almost double national rates, have largely been omitted from studies of the potential impact of tobacco regulations. AppalTRuST’s overarching goal is to investigate the impact of Federal Drug Administration Center for Tobacco Products (FDA CTP) regulatory changes on tobacco product use in rural communities and examine variation based on relative rurality. The FDA regulatory policies have an outsized potential to reduce tobacco-related disparities in rural Appalachia and the rest of rural America, given the relatively limited disincentives for use in these areas (i.e., few smoke-free laws and low tobacco taxes). The goal of Project 1 (P1) is to close the rural tobacco disparities knowledge gap by documenting tobacco use behaviors and related factors over time among Appalachian KY adults (18+ years) to inform current and future FDA regulations. P1 addresses the Scientific Domain of Behavior and will be guided by the Health Belief Model (HBM). The HBM provides a framework to evaluate associations of knowledge, attitudes, perceptions, and external cues with tobacco use behaviors. P1 will use the AppalTRuST Cohort to enroll 2,000 participants using a longitudinal cohort design that will collect participant data every 6 months for four years. We will recruit adults 18+ years from two catchment areas comprising 8 Appalachian KY counties; these two areas represent a range of rurality and will allow us to make not only catchment comparisons between a rural area and peri- urban one (i.e., partly urbanized rural areas), but also to assess for associations between tobacco use indicators and relative rurality within each catchment area. In addition, 40 participants from the Cohort per year will complete key informant interviews to assess opinions about tobacco products and regulations and allow us to make annual updates to the survey. We will address the following aims: (1) evaluate baseline prevalence and longitudinal trends in the use of conventional (cigarettes, smokeless tobacco, hookah, cigars/cigarillos, and pipes) and novel (e-cigarettes, nicotine pouches, heated tobacco products, and very low nicotine [VLN] cigarettes) tobacco products, including initiation, continuation, switching, cessation, and dual/poly-use among Appalachian adults, testing for the effect of rurality and controlling for individual- and county-level demographics; (2) assess changes over time in knowledge, attitudes, and perceptions relative to tobacco product characteristics (including flavors/menthol and VLN), among Appalachian KY adults, while evaluating the effect of rurality and controlling for demographics; and (3) explore perceived benefits, risks, and intentions to use novel tobacco products among current tobacco product users and individuals susceptible to initiating novel product use, with annual key informant interviews to capture reaction to changes in the product and regulatory landscape. We will evaluate the effects of the introduction of novel products and potential restrictions on flavored and high-nicotine products in rural communities so that regulatory decisions will be made using a health equity lens and be guided by a definition of rurality that is diverse and heterogeneous.

摘要-项目1 农村人口的烟草使用率几乎是全国的两倍， 烟草法规的潜在影响。AppalTRuST的首要目标是调查 烟草制品联邦药品管理局中心（FDA CTP）对烟草制品的监管变更 在农村社区使用，并检查基于相对农村的变化。FDA的监管政策有一个 鉴于减少阿巴拉契亚农村和美国其他农村地区与烟草相关的差异的巨大潜力 在这些领域中使用的相对有限的抑制因素（即，无烟法律少，烟草税低）。的 项目1（P1）的目标是通过记录烟草使用情况，缩小农村烟草知识差距 肯塔基州阿巴拉契亚成年人（18岁以上）随着时间的推移的行为和相关因素，为当前和未来提供信息 FDA法规。P1解决了行为的科学领域，并将由健康信念模型指导 （HBM）. HBM提供了一个框架，以评估知识，态度，感知， 烟草使用行为的外部线索。P1将使用AppalTRuST队列入组2，000名受试者 使用纵向队列设计，每6个月收集一次参与者数据，持续4年。我们将招募 来自两个集水区的18岁以上的成年人，包括8个阿巴拉契亚肯塔基州县;这两个地区代表了 一系列的乡村性，将使我们不仅可以在农村地区和非农村地区之间进行流域比较， 城市一（即，部分城市化的农村地区），但也评估烟草使用之间的关联 指标和每个集水区内的相对农村化程度。此外，每年有40名来自队列的参与者 将完成关键线人访谈，以评估有关烟草产品和法规的意见， 对调查进行年度更新。我们将致力于以下目标：（1）评估基线患病率 和使用传统（香烟、无烟烟草、水烟、雪茄/小雪茄， 和管道）和新型（电子烟，尼古丁袋，加热烟草产品，和非常低的尼古丁[VLN] 香烟）烟草制品，包括开始、继续、转换、停止和双重/多种用途， 阿巴拉契亚成年人，测试农村的影响和控制个人和县一级 人口统计学;（2）评估与烟草相关的知识、态度和认知随时间的变化 产品特征（包括香料/薄荷醇和VLN），在阿巴拉契亚肯塔基州成年人中，同时评估 农村化和控制人口统计学的影响;（3）探索感知的利益，风险和意图 在目前的烟草产品使用者和容易引发新烟草产品的个人中使用新烟草产品， 新产品的使用，每年与关键知情人进行访谈，以了解对产品变化的反应， 监管格局。我们将评估引进新产品和潜力的效果 限制农村社区的调味和高尼古丁产品，以便监管决定将 从健康公平的透镜出发，以多样化和异质性的农村定义为指导。