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，但这些研究在很大程度上被忽略了。 烟草法规的潜在影响。 AppalTruST 的总体目标是调查以下因素的影响： 联邦烟草制品药物管理局中心 (FDA CTP) 对烟草制品的监管变化 在农村社区中使用并检查基于相对农村性的变化。 FDA 的监管政策有 鉴于阿巴拉契亚农村地区和美国其他农村地区减少烟草相关差异的巨大潜力 在这些领域使用的限制相对有限（即很少有无烟法律和低烟草税）。这 项目 1 (P1) 的目标是通过记录烟草使用情况来缩小农村烟草知识差距 阿巴拉契亚肯塔基州成年人（18 岁以上）随时间的行为和相关因素，为当前和未来提供信息 FDA 法规。 P1 涉及行为的科学领域，并将以健康信念模型为指导 （HBM）。 HBM 提供了一个框架来评估知识、态度、感知和 烟草使用行为的外部线索。 P1 将使用 AppalTRUST 队列来招募 2,000 名参与者 使用纵向队列设计，将在四年内每 6 个月收集一次参与者数据。我们将招募 来自肯塔基州 8 个阿巴拉契亚县的两个流域的 18 岁以上成年人；这两个区域代表 范围的农村地区，使我们不仅能够对农村地区和周边地区进行流域比较 城市地区（即部分城市化的农村地区），还评估烟草使用之间的关联 每个流域内的指标和相对农村性。此外，每年有 40 名队列参与者 将完成关键知情人访谈，以评估有关烟草产品和法规的意见，并允许我们 对调查进行年度更新。我们将实现以下目标：（1）评估基线患病率 传统香烟（香烟、无烟烟草、水烟、雪茄/小雪茄、 和烟斗）和新型（电子烟、尼古丁袋、加热烟草产品和极低尼古丁 [VLN] 香烟）烟草制品，包括开始使用、继续使用、转换、停止以及双重/多用途 阿巴拉契亚成年人，测试乡村的影响并控制个人和县级 人口统计； (2) 评估与烟草相关的知识、态度和看法随时间的变化 阿巴拉契亚肯塔基州成年人的产品特征（包括口味/薄荷醇和 VLN），同时评估 农村地区的影响和人口统计控制； (3) 探索感知的收益、风险和意图 在当前烟草产品使用者和易感人群中使用新型烟草产品 新颖的产品使用，每年进行关键知情人访谈，以捕捉对产品变化的反应 监管环境。我们将评估引入新产品的效果和潜力 对农村社区的调味和高尼古丁产品进行限制，以便监管决策 使用健康公平的视角制定，并以多样化和异质性的农村定义为指导。