Project 2

项目总结 项目2(P2)：非燃性烟草产品在年度协定中的纵向使用模式(共同领导， 巴林顿-特里米斯/休斯-哈尔伯特)。 P2检查了口服尼古丁产品(ONPs)和电子烟在不利的纵向Aya烟草中的作用 产品使用结果，以及驱动这些结果的产品特性和人群。要完成 这项工作，P2将：a)将正在进行的青少年准队列(n=2 619)中的每半年一次的调查扩展到年青人 (B)建立一个新的青少年队列(n=2 500人)，从14至18岁开始每半年进行一次调查。 在这两个队列中，调查将衡量ONPs、电子烟和其他产品的模式和产品特征 每波使用的烟草产品，辅以一个新的离散选择任务，该任务将评估隐含的 对不同口味和尼古丁浓度的ONPs和电子烟的偏好。目标1是确定 使用ONP是否与随后的电子烟和可燃烟草使用风险相关，以及 AYA之间的升级。我们假设ONP的使用频率将预测随后的电子烟和 可燃烟草的使用：(A)开始、(B)频率和(C)强度。目标2是识别产品 增加Aya使用升级和依赖风险的新型ONPs和电子烟的特征 症状。我们假设Aya ONP和电子烟的使用频率和强度有进展的风险， 而使用ONPs和e-NPS并对其有隐性偏好的AYA的依赖症状水平将更高。 具有以下特征的香烟：(A)尼古丁浓度很高与尼古丁浓度高或低的香烟； 命名含糊的概念口味，明确命名为水果、薄荷、薄荷或冰+水果混合口味与 无香料产品或烟草香料；以及(C)促进更分散使用的设计。目标3是评估 不同人群的ONP启动、使用升级和多种产品使用的不同模式。我们 假设具有较低社会经济地位或性/性别少数地位的AYA将有更高的风险：(A) ONP使用开始，(B)ONP使用频率和强度随时间升级，以及(C)多产品使用(过去 30天使用ONP+其他产品)。对监管的影响：如果我们发现某些产品 类别(例如，ONP)、产品特征(例如，口味、尼古丁、谨慎的设计)或人群(例如， 性少数)与AYA的不良纵向尼古丁使用结果相关，针对这些 受监管限制的产品(例如，营销拒绝、强制执行)可能会带来好处。也就是说，这样 法规可能会阻止开始使用不可燃产品的AYA向更不利的方向发展 使用模式，包括被边缘化的Aya群体，历史上受到健康差距的影响。 FDA科学领域：行为、成瘾、营销。

PROJECT SUMMARY Project 2 (P2): Longitudinal Patterns of Non-Combustible Tobacco Product Use in AYAs (Co-Leaders, Barrington-Trimis/Hughes-Halbert). P2 examines the role of oral nicotine products (ONPs) and e-cigarettes in adverse longitudinal AYA tobacco product use outcomes, and the product characteristics and populations driving these outcomes. To accomplish this, P2 will: a) extend semi-annual surveys in an ongoing prospective cohort of adolescents (n=2,619) into young adulthood; b) establish a new adolescent cohort (n=2,500) who will be surveyed semiannually from age 14-18. In both cohorts, surveys will measure patterns and product characteristics of ONPs, e-cigarettes, and other tobacco products used at each wave, supplemented with a novel discrete choice task that will assess implicit preferences for ONPs and e-cigarettes in various flavors and nicotine concentrations. Aim 1 is to determine whether ONP use is associated with subsequent risk of e-cigarette and combustible tobacco use initiation and escalation among AYAs. We hypothesize that ONP use frequency will predict subsequent e-cigarette and combustible tobacco use: (a) initiation, (b) frequency, and (c) intensity. Aim 2 is to identify the product characteristics of novel ONPs and e-cigarettes that increase risk for AYA use escalation and dependence symptoms. We hypothesize that risk of progression in AYA ONP and e-cigarette use frequency and intensity, and dependence symptom levels will be higher in AYAs who use and have implicit preferences for ONPs and e- cigarettes with the following characteristics: (a) very high vs. high or low nicotine concentrations; (b) ambiguously-named concept flavors, explicitly-named fruit, menthol, mint, or ice+fruit hybrid flavors vs. unflavored products or tobacco flavors; and (c) designs that promote more discrete use. Aim 3 is to evaluate differential patterns of ONP initiation, use escalation, and poly-product use across diverse populations. We hypothesize that AYAs with low socioeconomic or sexual/gender minority statuses will be at higher risk of: (a) ONP use initiation, (b) escalation in ONP use frequency and intensity across time, and (c) poly-product use (past 30 day use of ONP+other products) across time. Implications for regulation: If we find that certain product classes (e.g., ONPs), product characteristics (e.g., flavors, nicotine, discreet designs), or populations (e.g., sexual minority status) are associated with adverse longitudinal nicotine use outcomes in AYAs, targeting these products in regulatory restrictions (e.g., marketing denials, enforcement) may yield benefits. Namely, such regulations could deter AYAs who start using non-combustible products from progressing toward more adverse patterns of use, including marginalized AYA groups historically subject to health disparities. FDA Scientific Areas: Behavior, Addiction, Marketing.