The effects of flavored e-cigarette sales bans on tobacco-use behaviors among youth and adults

调味电子烟销售禁令对青少年和成年人烟草使用行为的影响

• 批准号: 10805935
• 负责人: Rachel Denlinger-Apte
• 金额: $ 23.25万
• 依托单位: WAKE FOREST UNIVERSITY HEALTH SCIENCES
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-09-15 至 2025-08-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10805935
• 关键词: Adolescent; Adolescent and Young Adult; Adult; Affect; Age; Authorization documentation; Behavior; Behavioral; Benefits and Risks; Biological Markers; Candy; Cigarette; Cigarette Smoker; Clinical Trials; Cohort Studies; Consumption; Counseling; Data; Data Set; Devices; Electronic cigarette; Event; Frequencies; Fruit; Goals; Harm Reduction; Health Policy; Health Surveys; High School Student; Individual; Manufacturer; Menthol; Middle School Student; Natural experiment; Nature; Nicotine; Nicotine Dependence; Participant; Pattern; Policies; Population; Population Assessment of Tobacco and Health; Public Health; Quasi-experiment; Regulation; Reporting; Research Personnel; Risk; Sales; Science Policy; Smoke; Smoker; Smoking; Smoking Behavior; Tobacco; Tobacco use; United States Food and Drug Administration; Youth; age group; authority; cigarette smoking; combustible tobacco; design; electronic cigarette use; electronic cigarette user; electronic liquid; interest; nicotine replacement; nicotine use; prevent; skills; smoking cessation; success; tobacco flavor; tobacco products; tobacco regulation; tobacco regulatory science; tool; vaping; young adult

PROJECT SUMMARY In 2022, more than 2 million middle and high school students reported current e-cigarette use. The availability of flavored e-liquids makes e-cigarettes particularly appealing to youth, with nearly 85% reporting use of flavored e-cigarettes. The Food and Drug Administration (FDA) has taken action to regulate flavored e- cigarettes. In 2020, the agency banned prefilled, single-use cartridges containing e-liquids in ‘non-tobacco’ flavors (e.g., fruit, candy). It later targeted flavored disposable e-cigarettes—a previously unregulated device type that quickly gained popularity among youth following the initial flavor ban. Until last April, the FDA did not have regulatory authority over synthetic nicotine (vs. tobacco-derived nicotine), which some companies used as a loophole to keep selling flavored e-cigarettes. The ‘partial’ nature of the FDA’s prior regulations enabled e- cigarette manufacturers and retailers the opportunity to circumvent flavor regulations. However, six states (MD, RI, NJ, NY, MA, UT) enacted additional flavored e-cigarette bans, which serve as natural experiments to investigate whether more restrictive flavor bans are more effective in curtailing youth e-cigarette use. Conversely, e-cigarettes may also function as potentially less harmful alternatives for adults who smoke (AWS). Recent clinical trials report greater cigarette cessation rates among participants assigned to e- cigarettes compared to nicotine replacement or counseling only, suggesting potential benefits for those interested in quitting. Since flavored e-liquids are also highly preferred by AWS, e-cigarette flavor bans aimed at reducing AYA e-cigarette use may unintentionally discourage AWS from switching to potentially less harmful products. Thus, the project will examine the public health effects of stricter flavored e-cigarette regulations, taking into account both the potential benefits and risks. Using the Population Assessment of Tobacco and Health (PATH) Survey, we will investigate mechanisms by which statewide flavored e-cigarette bans affect e- cigarette and other tobacco product use (risks) as well as smoking cessation and reduction (benefits). We will leverage the longitudinal attribute of PATH to assess individual behavioral changes between subsequent waves. Using a quasi-experimental event study difference-in-differences estimation design, we will examine (1) changes in e-cigarette and cigarette use across age groups (12-17; 18-24 and 25+) and (2) use of e-cigarettes as a tool to quit or reduce smoking among AWS. PATH also includes a rich dataset of tobacco-related biomarkers, which we will analyze to further explore the impact of flavor bans. This study will contribute highly- relevant data on the positive and negative impact of flavored e-cigarette bans. The proposal aligns with the priorities outlined in RFA-OD-21-003 by examining the use pattern of flavored tobacco products and changes in tobacco use following bans on flavored e-cigarette sales. The study team is comprised of tobacco regulatory science and health policy researchers with the complementary expertise and skillsets needed to accomplish the goals of the proposal.

项目摘要 2022年，超过200万名初中和高中生报告目前使用电子烟。的可用性 调味电子液体的增加使得电子烟对年轻人特别有吸引力，近85%的人报告使用电子烟。 调味电子烟美国食品和药物管理局（FDA）已采取行动监管调味电子产品 香烟2020年，该机构禁止使用含有“非烟草”电子液体的预填充一次性墨盒 调味剂（例如，水果、糖果）。它后来瞄准了调味一次性电子烟-一种以前不受监管的设备 在最初的口味禁令之后，这种类型很快在年轻人中流行起来。直到去年四月，FDA还没有 对一些公司使用的合成尼古丁（与烟草衍生尼古丁相比）具有监管权 作为继续销售调味电子烟的漏洞FDA先前规定的“部分”性质使电子- 卷烟制造商和零售商有机会规避香料法规。然而，六个州（MD， RI，NJ，NY，MA，UT）颁布了额外的调味电子烟禁令，这些禁令作为自然实验， 调查更严格的口味禁令是否能更有效地减少青少年电子烟的使用。 相反，对于吸烟的成年人来说，电子烟也可能是潜在的危害较小的替代品 （AWS）。最近的临床试验报告说，分配到电子烟组的参与者戒烟率更高， 香烟相比，尼古丁替代或咨询，这表明潜在的好处， 有兴趣退出。由于调味电子液体也是AWS的首选，电子烟口味禁令旨在 减少AYA电子烟的使用可能会无意中阻止AWS转向潜在危害较小的电子烟 产品.因此，该项目将研究更严格的调味电子烟法规对公共健康的影响， 同时考虑到潜在的利益和风险。使用烟草人口评估， 健康（PATH）调查，我们将调查全州范围内的调味电子烟禁令影响电子烟的机制。 香烟和其他烟草制品的使用（风险）以及戒烟和减少吸烟（益处）。我们将 利用PATH的纵向属性来评估个体在随后的 波使用准实验性事件研究差异中差异估计设计，我们将检查（1） 各年龄组（12-17岁; 18-24岁和25岁以上）电子烟和香烟使用的变化;（2）电子烟的使用 作为AWS戒烟或减少吸烟的工具。PATH还包括与烟草相关的丰富数据集， 生物标志物，我们将分析这些生物标志物，以进一步探索风味禁令的影响。这项研究将大大有助于- 有关加香电子烟禁令的积极和消极影响的相关数据。该提案与 通过检查调味烟草产品的使用模式和变化，在RFA-OD-21-003中概述了优先事项 在禁止销售调味电子烟后，烟草使用量增加。该研究小组由烟草监管机构组成。 科学和卫生政策研究人员与互补的专业知识和技能，需要完成 提案的目标。