The Economics of Electronic Nicotine Delivery Systems: Advertising and Outcomes

 描述(由申请人提供)：电子尼古丁传递系统(END)，其中电子烟是最常见的副产品，是吸烟的不可燃替代品。直到最近才被引入美国市场，Ends得到了积极的推广，成年人和年轻人的使用量都在迅速增加。2013年，15%的成年人报告使用过电子烟，而四年前这一比例为0.6%。据报道，2012年有近178万初中生和高中生使用手机，比一年前的流行率高出一倍多。与此同时，广告在2010-2013年间增长了近15倍，年轻人对电视广告的曝光率在2011-2013年间增长了256%。人们对使用烟头的长期健康影响以及使用烟头对吸烟的影响知之甚少。这场监管辩论的核心是根本性的问题，即Ends是会让吸烟者远离危险的习惯，还是会引诱新的入门人员使用烟草，并导致新一代的尼古丁成瘾者。FDA和2014年卫生局局长的报告承认了这场辩论的双方，但强调了需要科学证据来告知这些问题。尽管来自29个州的总检察长呼吁更严格的营销限制， FDA在最近的裁决中没有包括任何这样的限制。没有关于末端广告和其他政策对末端模式和烟草使用的影响的严格证据基础。我们将通过首次全面分析杂志和电视上的End广告(占媒体广告支出的近90%)、在线横幅广告、社交媒体中End的广告对成年人和青少年的End使用模式的影响，以及End使用与吸烟行为之间的转变，包括前吸烟者的开始、戒烟和复发，来解决这一知识差距。此外，该项目还将提供一些初步估计，以告知州烟草控制项目经理确定的与其他政策因素有关的关键知识缺口，如无烟立法、对可获得性和使用的限制以及烟草税收和目的。我们将进一步探索广告和政策响应在相关利润率(启动与停止；密集与广泛)、年轻人和成年人以及各种其他社会人口因素中的异质性。这些问题将使用六个大规模的国家个人层面的数据集进行评估，每个数据集都具有不同的优势，其中许多具有纵向或回溯性信息，并与关于广告曝光的独特和详细的信息以及烟草控制政策的载体相匹配。这项拟议的研究对于了解END对公众健康的影响至关重要，并将提供必要的证据，以支持FDA关于营销的监管决定，并指导州政策制定者制定法规。

 DESCRIPTION (provided by applicant): Electronic Nicotine Delivery Systems (ENDS), of which e-cigarettes constitute the most common sub- product, are a non-combustible alternative to smoking. Only recently introduced into the US market, ENDS have been aggressively promoted, and use is increasing rapidly among both adults and youths. In 2013, 15% of adults reported having used e-cigarettes, compared with 0.6% just four years ago. Almost 1.78 million middle- and high-school students reported use in 2012, more than double the prevalence from just one year ago. Concurrently, advertising grew almost 15-fold between 2010-2013, with youth exposure to TV ads rising 256% between 2011 and 2013. Very little is known about the long-term health effects of using ENDS, and how ENDS use affects smoking. At the heart of the regulatory debate are fundamental questions regarding whether ENDS will draw cigarette smokers away from a dangerous habit or lure new initiates into tobacco use and lead to a new generation of nicotine addicts. The FDA and the 2014 Surgeon General's Report acknowledge both sides of this debate, but underscore the need for scientific evidence to inform these questions. Despite calls from attorneys general from 29 states for stricter marketing restrictions, the FDA refrained from including any such restrictions in its recent ruling. There is no rigorous evidence base on the impact of ENDS advertising and other policies on patterns of ENDS and tobacco use. We will address this knowledge gap by undertaking the first comprehensive analyses of the extent to which advertising of ENDS in magazines and on TV (constituting almost 90% of media ad spending), online as banner ads, and in social media impacts patterns of ENDS use among both adults and youths, as well as transitions between ENDS use and smoking behaviors, including initiation, cessation, and relapse among formers smokers. Furthermore, the project will also provide some of the first estimates to inform key knowledge gaps identified by state tobacco control program managers relating to other policy factors such as smoke-free legislation, restrictions on availability and use, and tobacco taxes and ENDS. We will further explore heterogeneity in the advertising and policy responses across relevant margins (initiation vs. cessation; intensive vs. extensive), across youths and adults, and across various other socio-demographic factors. These questions will be assessed using six large- scale national individual-level datasets, each with distinct strengths and many of them with longitudinal or retrospective information, matched with unique and detailed information on advertising exposure and a vector of tobacco control policies. The proposed research is essential for understanding the public health impact of ENDS and will provide the needed evidence to support the FDA's regulatory decisions over marketing as well as guide state policy-makers in their regulations.